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Objectives: To assess the relationship of white blood cell count (WBC) and other routinely collected inflammatory and clinical markers including stone size, stone position, and medical expulsive therapy use (MET), with spontaneous stone passage (SSP) in a large contemporary cohort of patients with acute ureteric colic, as there are conflicting data on the role of WBC and other inflammatory markers in SSP in patients with acute ureteric colic. Patients and methods: Multicentre retrospective cohort study coordinated by the British Urology Researchers in Surgical Training (BURST) Research Collaborative at 71 secondary care hospitals across four countries (UK, Republic of Ireland, Australia, and New Zealand). In all, 4170 patients presented with acute ureteric colic and a computed tomography confirmed single ureteric stone. Our primary outcome measure was SSP, as defined by the absence of need for intervention to assist stone passage (SP). Multivariable mixed effects logistic regression was used to explore the relationship between key patient factors and SSP. Results: In all, 2518 patients were discharged with conservative management and had further follow‐up with a SSP rate of 74% (n = 1874/2518). Sepsis after discharge with conservative management was reported in 0.6% (n = 16/2518). On multivariable analysis neither WBC, neutrophils count, nor C‐reactive protein (CRP) predicted SSP, with an adjusted odds ratio (OR) of 0.97 (95% confidence interval [CI] 0.91–1.04, P = 0.38), 1.06 (95% CI 0.99–1.13, P = 0.1) and 1.00 (95% CI 0.99–1.00, P = 0.17), respectively. MET also did not predict SSP (adjusted OR 1.11, 95% CI 0.76–1.61). However, stone size and stone position were significant predictors. SSP for stones <5 mm was 89% (95% CI 87–90) compared to 49% (95% CI 44–53) for stones ≥5–7 mm, and 29% (95% CI 23–36) for stones >7 mm. For stones in the upper ureter the SSP rate was 52% (95% CI 48–56), middle ureter was 70% (95% CI 64–76), and lower ureter was 83% (95% CI 81–85). Conclusion: In contrast to the previously published literature, we found that in patients with acute ureteric colic who are discharged with initial conservative management neither WBC, neutrophil count, nor CRP, helps determine the likelihood of SSP. We also found no overall benefit from the use of MET. Stone size and position are important predictors and our present findings represent the most comprehensive SP rates for each millimetre increase in stone size from a large contemporary cohort adjusting for key potential confounders. We anticipate that these data will aid clinicians managing patients with acute ureteric colic and help guide management decisions and the need for intervention. [ABSTRACT FROM AUTHOR]

1. Eradication of a single pest species from a multiply invaded island system may have unpredicted and detrimental impacts. Bergstrom et al. (2009) describe damage to vegetation following an increase in the number of rabbits on Macquarie Island. They propose that the increase in rabbit numbers was caused solely by eradication of cats. 2. However, their modeling is flawed and their conclusion that cats were controlling rabbit numbers is unsupported. We suggest the increase was because of some combination of four factors: reduced releases of Myxoma virus, abundant food after 20 years of vegetation recovery, release from cat predation and climate variability. 3. Recent high numbers of rabbits on Macquarie Island are not unprecedented; vegetation has been damaged in the past but has recovered. Rabbit numbers appear to be in decline again in the absence of both cats and Myxoma releases, suggesting that other factors can contribute to regulation of rabbit numbers in this system. 4. We do not agree with the implication that pest management could have been better integrated. Eradication techniques for rodents and rabbits on an island the size of Macquarie were unavailable when cat eradication was deemed necessary. The benefits to seabirds of cat eradication have been rapid. Our analysis further highlights the complexity of multiply invaded island ecosystems. [ABSTRACT FROM AUTHOR]