Influencing factors for surgical interventions for pediatric renal trauma and establishment of a no-mogram prediction model
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.
万方数据
维普
