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开发和内部验证预测慢性病在机器人辅助部分切除术后3年后升级阶段的诺姆图
Rocco Simone Flammia1, Umberto Anceschi2, Gabriele Tuderti2
1Department of Urology, IRCCS "Regina Elena" National Cancer Institute, Rome, Italy. roccosimone92@gmail.com.
International urology and nephrology
|October 17, 2023
概括
一个新的诺米图准确地预测了在机器人辅助部分切除术 (RAPN) 后慢性病 (CKD) 的升级风险. 该工具有助于确定四个风险类别,以改善患者咨询和管理.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 手术瘤学手术瘤学
背景情况:
- 机器人辅助部分切除术 (RAPN) 越来越多地用于局部瘤.
- 评估慢性病 (CKD) 在RAPN后升级的风险对于患者管理至关重要.
- 需要在RAPN后预测CKD进展的预测工具.
研究的目的:
- 开发和验证一种名谱,用于预测在接受RAPN的患者中CKD升级的3年风险.
- 确定影响CKD在RAPN后升级阶段的关键因素.
- 将患者分为不同的CKD进展风险类别.
主要方法:
- 针对针对局部瘤的RAPN治疗患者的多机构数据库查询.
- 定义显著的CKD升级阶段 (sCKD升级阶段) 是新发病的CKD阶段3a,3b或4/5.5.
- 使用C指数,引导,校准和回归树分析开发和验证nomogram.
主要成果:
- 总共有965名患者被分析,三年SCKD升级率为21.4%.
- 预测因素包括基线eGFR,单独的脏状况,多重病变,R.E.N.A.L. 分数,紧技术,以及术后的AKI.
- 诺米图表显示出强大的预测准确性 (C指数84%) 并确定了四个风险类别,其SCKD升级率显著不同 (1.3%至54.2%).
结论:
- 一种新型的诺米图准确地预测了RAPN.之后的3年SCKD升级风险.
- 诺米图有助于识别四个不同的患者风险类别.
- 建议对该工具进行外部验证,以加强患者咨询和管理策略.
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