Risk of Postoperative Renal Failure in Radical Nephrectomy and Nephroureterectomy: A Validated Risk Prediction Model
| Autor: | Albert El Hajj, Hani Tamim, Ali A. Nasrallah, Mira Itani, Charbel Gharios, Robert H. Habib, Dania S Bacha |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Urology medicine.medical_treatment Hematocrit Logistic regression Nephrectomy Nephroureterectomy Risk Assessment chemistry.chemical_compound Postoperative Complications Risk Factors medicine Humans Renal Insufficiency Chronic Risk factor Retrospective Studies Creatinine medicine.diagnostic_test business.industry Acute kidney injury medicine.disease chemistry Cohort business Kidney disease |
| Zdroj: | Urologia Internationalis. 106:596-603 |
| ISSN: | 1423-0399 0042-1138 |
| Popis: | Introduction: The study aimed to construct and validate a risk prediction model for incidence of postoperative renal failure (PORF) following radical nephrectomy and nephroureterectomy. Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database years 2005–2014 were used for the derivation cohort. A stepwise multivariate logistic regression analysis was conducted, and the final model was validated with an independent cohort from the ACS-NSQIP database years 2015–2017. Results: In cohort of 14,519 patients, 296 (2.0%) developed PORF. The final 9-factor model included age, gender, diabetes, hypertension, BMI, preoperative creatinine, hematocrit, platelet count, and surgical approach. Model receiver-operator curve analysis provided a C-statistic of 0.79 (0.77, 0.82; p < 0.001), and overall calibration testing R2 was 0.99. Model performance in the validation cohort provided a C-statistic of 0.79 (0.76, 0.81; p < 0.001). Conclusion: PORF is a known risk factor for chronic kidney disease and cardiovascular morbidity, and is a common occurrence after unilateral kidney removal. The authors propose a robust and validated risk prediction model to aid in identification of high-risk patients and optimization of perioperative care. |
| Databáze: | OpenAIRE |
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