儿童肾外伤外科干预影响因素分析及列线图预测模型的建立

doi:10.3760/cma.j.cn421158-20230825-00296

科研成果详情

题名	儿童肾外伤外科干预影响因素分析及列线图预测模型的建立
其他题名	Influencing factors for surgical interventions for pediatric renal trauma and establishment of a nomogram prediction model
作者	陈荣晨; 叶柯汛; 郑洪英; 徐磊; 夏立广; 陈聪德
发表日期	2024-02-15
发表期刊	中华小儿外科杂志影响因子和分区
语种	中文
原始文献类型	Periodical
关键词	列线图肾外伤外科干预儿童
其他关键词	Nomogram ; Renal trauma ; Surgical intervention ; Child
摘要	目的:探讨儿童单侧肾外伤后外科干预的独立危险因素并构建列线图预测儿童单侧肾外伤后外科干预的风险。方法:分析2011年9月至2021年9月温州医科大学附属第二医院收治的儿童单侧肾外伤的临床资料和影像学数据包括人口统计学、损伤特征、治疗和预后的数据。采用单因素分析筛选出儿童单侧肾外伤后外科干预的独立危险因素，多因素logistic回归模型分析危险因素并用R软件建立预测外科干预的列线图，根据曲线下面积和拟合度检验模型效果。结果:共有114例患儿纳入研究，开放性损伤3例，钝性损伤111例；其中17例患儿接受了外科干预，包括5例肾切除术，5例血管栓塞术及7例其他手术。多因素分析结果显示血肿大小/肾脏厚度比值、开放性损伤、入院4 h内出现休克、造影剂外渗及合并其他腹部器官损伤是儿童单侧肾外伤后外科干预的独立影响因素（均 P<0.05）。将这些因素纳入并成功构建列线图，列线图一致性指数为0.985，模型的校正曲线显示通过该列线图得出的外科干预预测值与实际观测值之间具有良好的一致性。结论:列线图模型拟合度好，能够为儿童单侧肾外伤的管理决策提供参考。
其他摘要	Objective:To explore independent risk factors for surgical interventions and construct a nomogram for predicting the risks of surgical interventions after unilateral renal trauma in children.Methods:From September 2011 to September 2021, the relevant clinical and imaging data were retrospectively reviewed for 114 children with unilateral renal trauma at Second Affiliated Hospital of Wenzhou Medical University. Demographic profiles, injury characteristics, treatment protocols and outcomes were recorded. Univariate analysis was utilized for screening for independent risk factors for surgical intervention after unilateral renal trauma. A multivariate Logistic regression model was employed for examining the risk factors. A nomogram for predicting surgical interventions was constructed with R software based upon the identified risk factors. And the model's performance was evaluated by area under the curve (AUC) and calibration curve.Results:Among them, there were 3 cases of open injury. A total of 17 operations were performed, including nephrectomy (n=5), vascular embolization (n=5) and other surgeries (n=7). Multivariate analysis indicated that ratio of hematoma size/renal thickness, open injuries, shock within 4h of hospitalization, extravasation of contrast agents and concomitant injuries to other abdominal organs were independent risk factors for surgical interventions (all P<0.05). A nomogram incorporating these factors was successfully constructed with a c-index of 0.985. And calibration curve implied at an excellent agreement between predicted and observed probabilities of surgical interventions. Conclusions:Based upon ratio of hematoma size/renal thickness, open injuries, shock within 4h of admission, concomitant injuries to other abdominal organs and extravasation of contrast agents, a nomogram model has been successfully established. The model has an excellent fit and it may provide references for clinical ecision-making in children with unilateral renal trauma.
出版者	Chinese Medical Journals Publishing House Co.Ltd
ISSN	0253-3006
卷号	45 期号:2 页码:126-131
DOI	10.3760/cma.j.cn421158-20230825-00296
页数	6
收录类别	万方 ; 维普 ; SCOPUS ; CSCD ; ISTIC ; 北大核心
URL	查看原文
SCOPUSEID	2-s2.0-85185586066
通讯作者地址	[Chen, Congde]Department of Pediatric Urology,Second Affiliated Hospital,Yuying Children's Hospital,Wenzhou Medical University,Key Municipal Laboratory of Children's Genitourinary Diseases,Wenzhou,325000,China
Scopus学科分类	Surgery;Pediatrics, Perinatology and Child Health
引用统计
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/214896
专题	附属第二医院附属第二医院_泌尿外科第二临床医学院、附属第二医院、育英儿童医院附属第二医院_外科
作者单位	温州医科大学附属第二医院，育英儿童医院儿童泌尿外科，温州市儿童泌尿生殖系统疾病重点实验室，温州　325000
第一作者单位	附属第二医院; 第二临床医学院，附属第二医院、育英儿童医院; 泌尿外科; 外科
通讯作者单位	附属第二医院
第一作者的第一单位	附属第二医院
推荐引用方式 GB/T 7714	陈荣晨,叶柯汛,郑洪英,等. 儿童肾外伤外科干预影响因素分析及列线图预测模型的建立[J]. 中华小儿外科杂志,2024,45(2):126-131.
APA	陈荣晨, 叶柯汛, 郑洪英, 徐磊, 夏立广, & 陈聪德. (2024). 儿童肾外伤外科干预影响因素分析及列线图预测模型的建立. 中华小儿外科杂志, 45(2), 126-131.
MLA	陈荣晨,et al."儿童肾外伤外科干预影响因素分析及列线图预测模型的建立".中华小儿外科杂志 45.2(2024):126-131.