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膀回流的早期自发解决从清空囊回流图:当代预测模型的比较
Adree Khondker1, Jin Kyu Kim2, Angela M Arlen3
1Division of Urology, Department of Surgery, The Hospital for Sick Children, Toronto, ON, Canada; Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Journal of pediatric urology
|May 14, 2025
概括
预测膀回流 (VUR) 的自发解消至关重要. 结合尿管直径比率 (UDR) 和qVUR的先进模型显示,与传统分级单独相比,预测准确度有所提高.
科学领域:
- 儿科泌尿外科 儿科泌尿外科
- 放射学 放射学是一门学科.
- 预测建模预测建模
背景情况:
- 膀肠回流 (VUR) 的自发解决是一个关键的临床结果.
- 未解决的VUR增加了感染和脏痕的风险.
- 目前的预测模型 (VURx,UDR,qVUR) 旨在分层风险并指导风险管理.
研究的目的:
- 通过整合当代预测措施来提高VUR解决方案的预测.
- 为了比较VURx,尿管直径比率 (UDR) 和qVUR与传统VUR分级的预测性能.
主要方法:
- 在1年后接受重复VCUG的初级VUR儿科患者的回顾性分析.
- 纳入标准:一年的随访VCUG或一年内突破性尿路感染的手术.
- 综合年龄,性别,横向性和VUR等级,mVURx,UDR或qVUR特征的多变量逻辑回归模型被分析为分辨率预测 (AUROC).
主要成果:
- 在141名儿童中,29% (21%) 在1年内经历了VUR解决.
- 较高的最大UDR和尿道宽度与较低的分辨率相关.
- 基于qVUR的模型显示了最高的预测性能 (AUROC=0.79),其次是mVURx (0.77),UDR (0.75) 和VUR等级 (0.74).
结论:
- 整合像qVUR和UDR这样的客观放射测量,可以提高VUR分辨率的预测.
- 结合其他因素 (性别,年龄,反流发病) 的模型可以提高预测准确度,而不仅仅是VUR等级.
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