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During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
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Related Experiment Video

Updated: Sep 13, 2025

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Nomogram for Predicting Postoperative Major Bleeding in Percutaneous Nephrolithotomy: A Retrospective Study.

Yifan Wu1, Jue Gong1, Chenyu Qiu1

  • 1Department of Urology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China.

European Urology Open Science
|August 4, 2025
PubMed
Summary

This study developed a nomogram to predict major bleeding risk after percutaneous nephrolithotomy (PCNL). The tool identifies key risk factors, aiding surgeons in preoperative assessments and enhancing patient safety.

Keywords:
Major bleedingNomogramPercutaneous nephrolithotomyRenal stoneRisk factors

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Area of Science:

  • Urology
  • Surgical Oncology
  • Nephrology

Background:

  • Percutaneous nephrolithotomy (PCNL) is a common procedure for kidney stones.
  • Postoperative major bleeding is a significant complication following PCNL.
  • Accurate risk stratification is crucial for patient management and surgical planning.

Purpose of the Study:

  • To develop and validate a predictive nomogram for major bleeding after PCNL.
  • To identify independent risk factors associated with postoperative bleeding.
  • To provide a tool for enhanced preoperative risk assessment in PCNL patients.

Main Methods:

  • Retrospective analysis of 493 patients undergoing unilateral PCNL.
  • Development of a nomogram using least absolute shrinkage and selection operator (LASSO) and multivariable logistic regression.
  • Temporal division into training (70%) and validation (30%) sets for model evaluation.

Main Results:

  • Six independent risk factors identified: solitary kidney, renal parenchymal thickness, surgical staging, surgical approach, tract size, and estimated glomerular filtration rate.
  • The nomogram demonstrated good predictive performance with an AUC of 0.81 (training set) and 0.84 (validation set).
  • Decision curve analysis confirmed the nomogram's clinical utility in predicting bleeding risk.

Conclusions:

  • The developed nomogram is an effective tool for estimating major bleeding risk post-PCNL.
  • The nomogram aids surgeons in preoperative decision-making by identifying high-risk individuals.
  • This tool can contribute to improved surgical safety and patient outcomes in PCNL procedures.