External Validation of Two Predictive Models for Postoperative Fever After Retrograde Intrarenal Surgery in Pediatric...

Area of Science:

• Pediatric Urology
• Surgical Outcomes
• Predictive Modeling

Background:

• Postoperative fever is a concern following retrograde intrarenal surgery (RIRS) in children.
• Accurate prediction of fever risk is crucial for patient management and resource allocation.
• Existing predictive models require validation in pediatric populations undergoing RIRS.

Purpose of the Study:

• To validate and compare the efficacy of two predictive models for postoperative fever in pediatric patients undergoing RIRS.
• To assess the reliability of these models using preoperative routine examination data.
• To identify key predictors associated with fever after RIRS in children.

Main Methods:

• A retrospective analysis of 124 pediatric patients who underwent RIRS between August 2014 and August 2020.
• Data including patient demographics, surgical parameters, and preoperative laboratory values were collected.
• Receiver Operating Characteristic (ROC) curves and Area Under the Curve (AUC) were used to compare the predictive performance of two nomograms.

Main Results:

• Twenty-one pediatric patients (16.9%) developed postoperative fever.
• Nomogram 1 showed significantly better predictive accuracy (AUC = 0.805) compared to Nomogram 2 (AUC = 0.664, p=0.025).
• C-reactive protein levels and irrigation volumes were identified as significant predictors of fever.

Conclusions:

• Nomogram 1 is a reliable and effective tool for predicting postoperative fever in pediatric patients undergoing RIRS.
• The findings support the use of Nomogram 1 for risk stratification and clinical decision-making in pediatric RIRS.
• Further prospective studies are warranted to confirm these findings in larger cohorts.