Xu Meijuan, Zhang Qiuxuan, Mo Xiaohui, Liu Yanmei, Peng Man, Ma Xuexia
Department of Urology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China.
Front Oncol. 2025 May 16;15:1528834. doi: 10.3389/fonc.2025.1528834. eCollection 2025.
To identify key factors influencing early postoperative ambulation in patients undergoing partial nephrectomy for renal tumors and to construct a predictive model for day-one ambulation based on these factors.
This retrospective study analyzed 137 patients who underwent partial nephrectomy for renal tumors at the Department of Urology, Sun Yat-sen Memorial Hospital, between October 2020 and June 2023. Patients were randomly divided into a training set (n=97) and a test set (n=40) in a 7:3 ratio. Univariate and multivariate logistic regression analyses were conducted to evaluate potential risk factors influencing postoperative ambulation.
Of the 137 patients, 116 were able to ambulate on the first postoperative day. Significant factors associated with early postoperative ambulation included age, hypertension, tumor size, serum cystatin C, blood urea nitrogen, renal artery clamping time, and intraoperative blood loss. A predictive model was constructed based on age, tumor size, and intraoperative blood loss, demonstrating strong accuracy with areas under the receiver operating characteristic (ROC) curve of 0.902 in the training set and 0.975 in the test set. Bootstrap calibration curves confirmed the model's predictive accuracy, and decision curve analysis (DCA) demonstrated a substantial clinical benefit.
Age, tumor size, and intraoperative blood loss are key predictors of day-one ambulation in patients undergoing partial nephrectomy. This predictive model provides clinicians with a reliable tool for assessing early postoperative mobility, supporting enhanced recovery protocols and improving patient outcomes.
确定影响肾肿瘤患者行部分肾切除术后早期活动的关键因素，并基于这些因素构建术后第1天活动能力的预测模型。
这项回顾性研究分析了2020年10月至2023年6月在中山大学孙逸仙纪念医院泌尿外科接受肾肿瘤部分肾切除术的137例患者。患者按7:3的比例随机分为训练集（n = 97）和测试集（n = 40）。进行单因素和多因素逻辑回归分析，以评估影响术后活动的潜在风险因素。
137例患者中，116例在术后第1天能够活动。与术后早期活动相关的显著因素包括年龄、高血压、肿瘤大小、血清胱抑素C、血尿素氮、肾动脉阻断时间和术中出血量。基于年龄、肿瘤大小和术中出血量构建了预测模型，在训练集中受试者操作特征（ROC）曲线下面积为0.902，在测试集中为0.975，显示出很强的准确性。自举校准曲线证实了模型的预测准确性，决策曲线分析（DCA）显示出显著的临床益处。
年龄、肿瘤大小和术中出血量是肾肿瘤部分肾切除术患者术后第1天活动能力的关键预测因素。该预测模型为临床医生提供了一个评估术后早期活动能力的可靠工具，有助于加强康复方案并改善患者预后。
