title: The lithotripsy table height: a novel predictor of outcome in shockwave lithotripsy.
abstract: BACKGROUND
  Outcome of Extracorporeal Shockwave Lithotripsy (SWL) is determined by physical factors that affect stone fragmentation and clearance.
  
  
  OBJECTIVE
  To evaluate the predictive value of the Lithotripsy Table Height (LTH) in SWL outcome. Lithotripsy Table Height (LTH) is a variable that represents skin to therapy head distance, and it is proportional to the energy that reaches the stone.
  
  
  METHODS
  A prospective study enrolled patients undergoing SWL for radiopaque urinary stones. All procedures were performed using a Modulith SLX (Karl Storz, Germany) Lithotripter. Patient weight, height and age; stone location and size; number of shock waves delivered, and LTH were recorded. One month post-procedure a KUB was obtained. Logistic regression analysis was used to evaluate the effects of these variables on stone-free outcome. A ROC curve was plotted.
  
  
  RESULTS
  Fifty-six patients were enrolled. After one month follow-up, overall success rate (Stone Free) was 83.9% (n = 47). LTH was the only independent predictor of outcome in both univariate and multivariate analysis (p = 0.029). Stone size (p = 0.45) and BMI (p = 0.32) were not significant. In the ROC curve, LTH showed an Area under the Curve = 0.791. Patients with LTH < 218 (n = 8) had relative risk of residual stones = 7.5, odds Ratio: 6.6 (Stone free rate 37.5% vs. 91.5%).
  
  
  CONCLUSIONS
  LTH appears to be an independent predictor of SWL outcome. High success rates can be expected if LTH > 218. Patients with lower LTH had a less effective therapy, therefore, worse stone fragmentation and clearance. These findings may help improve patient selection for SWL therapy.
authors.affiliation: Department of Urology, Hospital Clinico Universidad de Chile, Santiago, Chile.
authors.forename: Enrique
authors.initials: E
authors.lastname: Ossandon
authors.forename: Pedro
authors.initials: P
authors.lastname: Recabal
authors.forename: Cristian
authors.initials: C
authors.lastname: Acevedo
authors.forename: Jose Miguel
authors.initials: JM
authors.lastname: Flores
authors.forename: Fernando
authors.initials: F
authors.lastname: Marchant
mesh_terms: D000328:Adult; D001827:Body Height; D001835:Body Weight; D002677:Chile; D004867:Equipment Design / Q000592:standards; D005260:Female; D006801:Humans; D008096:Lithotripsy / Q000295:instrumentation* / Q000379:methods; D008297:Male; D008875:Middle Aged; D058638:Operating Tables / Q000592:standards*; D056888:Patient Positioning / Q000295:instrumentation / Q000379:methods; D011446:Prospective Studies; D012372:ROC Curve; D012044:Regression Analysis; D014545:Urinary Calculi / Q000473:pathology / Q000628:therapy*