构建和验证通过皮肤进行利切除术后尿液败血症的诺米克预测模型
Zuze Qiu1, Shun Zhan1, Yuanming Song1
1Department of Urology, Affiliated Hospital of Zunyi Medical University, Zunyi, China.
World journal of urology
|March 13, 2024
概括
这项研究开发了一种名谱,用于预测皮肤穿透性利切除术 (PCNL) 后的败血症. 关键的风险因素包括阳性尿液检测,更长的手术时间和更大的石头大小,有助于在PCNL后尿液败血症的早期干预.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 腎臟病學 (nephrology) 是一種醫學.
- 传染性疾病 传染性疾病
背景情况:
- 皮肤穿透后瘤切除术 (PCNL) 败血症是一种显著的并发症.
- 早期识别和干预对于管理尿道的管理至关重要.
- 需要准确的预测工具来评估患者的风险.
研究的目的:
- 构建和验证用于预测PCNL后败血症的临床名谱.
- 帮助泌尿科医生早期识别和干预泌尿病症.
- 为PCNL患者提供基于证据的风险评估工具.
主要方法:
- 对946名接受PCNL治疗的患者进行脏或上尿道结石的回顾性研究 (2019年1月至2022年9月).
- 单变量和多变量逻辑回归分析以确定风险因素.
- 使用ROC,校准和决策曲线分析构建和验证名图.
主要成果:
- 69名患者 (7.29%) 在PCNL后发生了尿液败血症.
- 确定了独立的危险因素:尿酸化物阳性 (OR=5.9),尿酸培养阳性 (OR=7.54),手术时间≥120分钟 (OR=20.93),石块大小≥30毫米 (OR=13.81).
- 诺莫格拉姆显示高精度 (AUC=0.909在开发中,0.922在验证中) 具有良好的校准和临床实用性.
结论:
- 阳性手术前尿液培养,阳性尿酸,手术时间≥120分钟,石块大小≥30毫米是PCNL后败血症的独立预测因素.
- 开发的诺米图有效地评估了PCNL后尿道败血症的风险.
- 这种工具可以支持临床决策,以预防和管理PCNL后的尿.
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