Development and internal validation of a nomogram to predict perioperative complications after flexible ureteroscopy for renal stones in overnight ureteral catheterization cases
Development and internal validation of a nomogram to predict perioperative complications after flexible ureteroscopy for renal stones in overnight ureteral catheterization cases
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DOI：
10.1007/s00345-019-03023-y
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发表时间：
2019-11-29
影响因子：
3.4
通讯作者：
Matsuzaki, Junichi
中科院分区：
文献类型：
--
作者：
Komeya, Mitsuru;Odaka, Hisakazu;Matsuzaki, Junichi
目的 通过开发和内部验证列线图来确定危险因素，以预防肾结石 fURS 术后过夜输尿管插管病例的围手术期并发症。方法 我们回顾性检查了 309 例肾结石单次 fURS 手术后过夜输尿管插管的患者。 fURS 程序是基于碎片技术进行的。术后第 1 天拔除输尿管导管。在该组中，将出现围手术期并发症的患者（并发症组）与未出现并发症的患者（非并发症组）进行比较。并发症组包括77例Clavien-Dindo分级评分为I、II、III或IV级和/或住院期间体温超过37.5℃的患者。结果总结石量、结石清除率、围手术期并发症发生率和手术时间分别为1.39 mL、94.8%、24.9%和62 min。仅在 4 例病例 (1.3%) 中观察到 Clavien-Dindo III 级或 IV 级的严重并发症。多变量评估揭示了 fURS 过夜导尿术后围手术期并发症的五个独立预测因素：年龄 (p = 0.11)、性别 (p = 0.067)、结石体积 (p = 0.33)、Hounsfield 单位 (p = 0.16) 和输尿管狭窄 (p = 0.018)。我们使用这些参数开发了列线图来预测 fURS 后的围手术期并发症。结论 我们开发了一个针对肾结石 fURS 术后过夜导尿患者围手术期并发症的预测模型。该模型可以选择并发症风险较低的患者。
Purpose To identify risk factors by developing and internally validating a nomogram for preventing perioperative complications in overnight ureteral catheterization cases after fURS for kidney stones. Methods We retrospectively examined 309 patients with overnight ureteral catheterization after single fURS procedures for renal stones. fURS procedures were performed based on the fragmentation technique. The ureteral catheter was removed on postoperative day 1. Within this group, patients who experienced perioperative complications (complication group) were compared with those who did not experience complications (non-complication group). The complication group included 77 patients whose Clavien-Dindo classification score was I, II, III, or IV and/or those whose body temperature during hospitalization was over 37.5 degrees C. Results The overall stone volume, stone-free rate, incidence of perioperative complications, and procedure duration were 1.39 mL, 94.8%, 24.9%, and 62 min, respectively. Severe complications of a Clavien-Dindo level III or IV were observed in only four cases (1.3%). Multivariate assessment revealed five independent predictors of perioperative complications after fURS with overnight catheterization: age (p = 0.11), sex (p = 0.067), stone volume (p = 0.33), Hounsfield units (p = 0.16), and narrow ureter (p = 0.018). We developed a nomogram to predict perioperative complications after fURS using these parameters. Conclusions We developed a predictive model for perioperative complications of patients with overnight catheterization after fURS for renal stones. This model could select patients who were at a low risk of complications.