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首页> 外文期刊>BJU international >Nomogram for predicting the likelihood of postoperative surgical complications in patients treated with partial nephrectomy: a prospective multicentre observational study (the RECORd 2 project)
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Nomogram for predicting the likelihood of postoperative surgical complications in patients treated with partial nephrectomy: a prospective multicentre observational study (the RECORd 2 project)

机译：预测术后术后患者术后手术并发症的可能性的罗维图：一项潜在的多环境观察研究（记录2项目）

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Objective To identify meaningful predictors and to develop a nomogram of postoperative surgical complications in patients treated with partial nephrectomy (PN). Patients and Methods We prospectively evaluated 4308 consecutive patients who had surgical treatment for renal tumours, between 2013 and 2016, at 26 Italian urological centres (RECORd 2 project). A multivariable logistic regression for surgical complications was performed. A nomogram was created from the multivariable model. Internal validation processes were performed using bootstrapping with 1000 repetitions. Results Overall, 2584 patients who underwent PN were evaluated for the final analyses. The median (interquartile [IQR]) American Society of Anesthesiologists (ASA) score was 2 (2-3). In all, 72.4% of patients had clinical T1a (cT1a) stage tumours. The median (IQR) Preoperative Aspects and Dimensions Used for an Anatomical (PADUA) score was 7 (6-8). Overall, 34.3%, 27.7%, 38% of patients underwent open PN (OPN), laparoscopic PN (LPN), and robot-assisted PN (RAPN). Overall and major postoperative surgical complications were recorded in 10.2% and 2.5% of patients, respectively. At multivariable analysis, age, ASA score, cT2 vs cT1a stage, PADUA score, preoperative anaemia, OPN and LPN vs RAPN, were significant predictive factors of postoperative surgical complications. We used these variables to construct a nomogram for predicting the risk of postoperative surgical complications. At decision curve analysis, the nomogram led to superior outcomes for any decision associated with a threshold probability of >5%. Conclusion Several clinical predictors have been associated with postoperative surgical complications after PN. We used this information to develop and internally validate a nomogram to predict such risk.
机译：目的识别有意义的预测因子，并在患有部分肾切除术（PN）治疗的患者中制定术后手术并发症的纯图。患者和方法我们在2013年至2016年间预期评估了4308名患有肾脏肿瘤的手术治疗的患者，在2013年至2016年间，在26条意大利泌尿目中中心（记录2项目）。进行了对手术并发症的多变量逻辑回归。从多变量模型中创建了一个铭文。使用具有1000重复的引导映射执行内部验证进程。结果总体而言，评估了2584名接受PN的患者进行最终分析。中位数（interlyle [IQR]）美国麻醉学家（ASA）得分为2（2-3）。总之，72.4％的患者患有临床T1A（CT1A）阶段肿瘤。用于解剖学（Padua）评分的中位数（IQR）术前方面和尺寸为7（6-8）。总体而言，34.3％，27.7％，38％的患者接受开放的PN（OPN），腹腔镜PN（LPN）和机器人辅助PN（RAPN）。总体而主要的术后手术并发症分别以10.2％和2.5％的患者记录。在多变量分析中，年龄，ASA得分，CT2与CT1A阶段，帕多瓦评分，术前贫血，OPN和LPN与RAPN，是术后手术并发症的显着预测因素。我们使用这些变量来构建用于预测术后手术并发症的风险的NOM图。在判定曲线分析中，NOMA画面导致了与> 5％阈值概率相关的任何决定的卓越结果。结论PN后几种临床预测因子与术后手术并发症有关。我们使用这些信息来开发和内部验证一个墨水图来预测这些风险。

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