Establishment and verification of a prediction model of venous thromboembolism in elderly patients with urinary system calculi after endoscopic surgery
10.3969/j.issn.1009-8291.2024.05.009
- VernacularTitle:老年泌尿系统结石患者内镜手术后发生静脉血栓栓塞症预测模型的建立及评估
- Author:
Songlin CHEN
1
;
Jun QU
;
Cong HUANG
;
Jinzhu XIAO
Author Information
1. 海南省肿瘤医院泌尿外科,海南海口 570100
- Keywords:
elderly;
urinary system calculi;
endoscopic surgery;
venous thromboembolism;
nomogram
- From:
Journal of Modern Urology
2024;29(5):427-431
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the risk factors of venous thromboembolism(VTE)after endoscopic surgery in elderly patients with urinary system calculi,construct a prediction model and validate it.Methods A retrospective analysis was conducted on the clinical data of 402 elderly patients(≥ 60 years)with urinary system calculi who underwent endoscopic surgery in our hospital during Jan.2018 and Jan.2023.The patients were divided into VTE group(n=43)and non-VTE group(n=359)based on whether VTE occurred after surgery.Risk factors of VTE were screened with univariate and multivariate logistic regression analyses.Based on the screening results(P＜0.05 for the factor),a nomogram prediction model was established,the receiver operating characteristic(ROC)curve was drawn,the area under the curve(AUC)was calculated to determine the efficacy of the model,and a calibration chart was drawn to determine the accuracy of the model.Results Univariate analysis showed that age＞70 years,body mass index(BMI)≥30,VTE history,history of malignant tumors,diabetes,operation time＞180 min,diuretic use during operation,and postoperative ambulation time＞24 h were risk factors of VTE(P＜0.05).Logistic regression analysis showed that age＞70 years,BMI ≥ 30,history of VTE,history of malignant tumors,and operation time＞180 min were independent risk factors of VTE(P＜0.05).The AUC in the ROC curve of the validation set data was 0.789(95％CI:0.731-0.848,P＜0.001).The calibration chart showed that the calibration curve was close to the standard curve(Brier=0.13).Conclusion Age＞70 years,BMI ≥30,history of VTE,history of malignant tumors,and surgery time＞180 min are independent risk factors of postoperative VTE in elderly patients with urinary system calculi undergoing endoscopic surgery.The prediction model can effectively predict the risk factors of postoperative VTE.
