Department of Urology and Guangdong Key Laboratory of Urology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
World J Urol. 2023 Mar;41(3):843-848. doi: 10.1007/s00345-023-04291-5. Epub 2023 Jan 31.
To develop a new prediction model for assessing the severe hemorrhage events in post mini-percutaneous nephrolithotomy (mini-PCNL) patients and internally validate it, thus to guide decision making in clinical practice.
The patients who underwent mini-PCNL were retrospectively reviewed. Potential risk factors were included as prediction variables for multivariate logistic regression analysis to identify independent risk factors, and prediction model was constructed. The predictive ability of the model was evaluated using the Concordance index (C-index) and Brier score. Bootstrapping resampling technique was used to perform internal validation. The related packages in R were used to generate the web application based on the prediction model.
Multiple-tract was the strongest predictor of severe hemorrhage following mini-PCNL. Other risk factors were none or mild hydronephrosis, congenital anomalies of urinary system, urinary tract infection, operation time and stone peak Hounsfield unit. A prediction model was constructed to assess the probability of severe hemorrhage after mini-PCNL. The C-index and Brier score were 0.731 and 0.093, respectively after correcting for optimism, which signified the excellent discrimination and calibration.
A new prediction model was developed to estimate risk of severe hemorrhage after mini-PCNL. It had been internally validated with good discrimination and calibration. The prediction model might be beneficial for endourologists in surgical decision-making and risk aversion.
开发一种新的预测模型，用于评估经皮肾镜取石术后（mini-PCNL）患者严重出血事件，并对其进行内部验证，从而为临床实践中的决策提供指导。
回顾性分析接受 mini-PCNL 的患者。将潜在的危险因素纳入多变量逻辑回归分析，以确定独立的危险因素，并构建预测模型。采用一致性指数（C-index）和 Brier 评分评估模型的预测能力。采用Bootstrapping 重采样技术进行内部验证。使用 R 中的相关包基于预测模型生成网络应用程序。
多通道是 mini-PCNL 后严重出血的最强预测因子。其他危险因素包括无或轻度肾积水、泌尿系统先天畸形、尿路感染、手术时间和结石峰值 Hounsfield 单位。构建了一个预测模型来评估 mini-PCNL 后严重出血的概率。校正后，C-index 和 Brier 评分分别为 0.731 和 0.093，表明具有良好的区分度和校准度。
开发了一种新的预测模型来估计 mini-PCNL 后严重出血的风险。经过内部验证，具有良好的区分度和校准度。该预测模型可能有助于腔内泌尿外科医生在手术决策和风险规避方面。
