Risk factors and prediction model of bleeding after lithotripsy for upper ureteral calculi
Objective To study the risk factors of bleeding after lithotripsy for upper ureteral calculi,and to establish a prediction model.Methods Three hundred and ten patients with upper ure-teral calculi underwent lithotripsy in our hospital from February 2021 to February 2022 were enrolled,and classified into two groups according to the postoperative bleeding status,bleeding group(33 ca-ses)and non-bleeding group(277 cases).Multivariate logistics regression model was used to screen out the independent risk factors of postoperative bleeding.The nomogram prediction model was estab-lished based on independent risk factors,and the discriminative ability and predictive accuracy of the nomogram was verified.Results Compared with the non bleeding group,the operation time ≥60 min,body mass index(BMI)＞24 kg/m2,history of diabetes and the proportion of residual stones in the bleeding group were significantly higher,and the differences were statistically significant(all P＜0.05).Multivariate logistic analysis showed that operation time ≥60 min,BMI＞24 kg/m2,history of diabetes mellitus and presence of residual stones were independent risk factors for postoperative bleed-ing(all P＜0.05).The nomogram showed that the total score of operation time ≥ 60 min was 98 points,BMI＞24 kg/m2 was 61 points,diabetes history was 45 points,and the presence of residual stones was 75 points.The predicted values of the calibration curves of the nomogram model are consist-ent with the actual values.Hosmer lemeshow goodness of fit test showed that the model fitted well(x2=8.199,P=0.150).The area under the receiver operating characteristic curve(ROC)was 0.816.Con-clusions The operation time,BMI,history of diabetes,and presence of residual stones are all risk factors for postoperative bleeding after lithotripsy for upper ureteral calculi,and the nomogram predic-tion model is found to have high predictive performance.
万方数据
维普
