Nomogram for predicting the likelihood of postoperative surgical complications in patients treated with partial nephrectomy: a prospective multicentre observational study (the RECORd 2 project)

Alchiede Simonato, Francesca Maria Carini, Riccardo Schiavina, Umberto Capitanio, Francesco Berardinelli, Marco Borghesi, Riccardo Campi, Francesco Marson, Alessandro Larcher, Claudio Simeone, Alessandro Volpe, Alessandro Antonelli, Daniele Amparore, Mario Falsaperla, Maria Furlan, Nicola Longo, Carlo Terrone, Angelo Porreca, Fabrizio Di Maida, Elisabetta CostantiniRiccardo Tellini, Maurizio Barale, Walter Artibani, Andrea Mari, Julian Daja, Vincenzo Altieri, Marco Borghesi, Antonio Celia, Eugenio Brunocilla, Andrea Minervini, Luigi Schips, Marco Roscigno, Vincenzo Li Marzi, Paolo Gontero, Pierluigi Bove, Luigi Da Pozzo, Alchiede Simonato, Donata Villari, Francesco Porpiglia, Francesca Pisano, Giuseppe Morgia, Giuseppe Vespasiani, Vincenzo Mirone, Carlo Trombetta, Salvatore Siracusano, Roberto Bertini, Vincenzo Ficarra, Emanuele Montanari, Claudio Simeone, Cristian Fiori, Cesare Selli, Francesco Montorsi, Marco Carini, Antonella Antonelli, Federica Antonia Celia, Maria Francesca Pisano

Risultato della ricerca: Article

7 Citazioni (Scopus)

Abstract

Objective: To identify meaningful predictors and to develop a nomogram of postoperative surgical complications in patients treated with partial nephrectomy (PN). Patients and Methods: We prospectively evaluated 4308 consecutive patients who had surgical treatment for renal tumours, between 2013 and 2016, at 26 Italian urological centres (RECORd 2 project). A multivariable logistic regression for surgical complications was performed. A nomogram was created from the multivariable model. Internal validation processes were performed using bootstrapping with 1000 repetitions. Results: Overall, 2584 patients who underwent PN were evaluated for the final analyses. The median (interquartile [IQR]) American Society of Anesthesiologists (ASA) score was 2 (2–3). In all, 72.4% of patients had clinical T1a (cT1a) stage tumours. The median (IQR) Preoperative Aspects and Dimensions Used for an Anatomical (PADUA) score was 7 (6–8). Overall, 34.3%, 27.7%, 38% of patients underwent open PN (OPN), laparoscopic PN (LPN), and robot-assisted PN (RAPN). Overall and major postoperative surgical complications were recorded in 10.2% and 2.5% of patients, respectively. At multivariable analysis, age, ASA score, cT2 vs cT1a stage, PADUA score, preoperative anaemia, OPN and LPN vs RAPN, were significant predictive factors of postoperative surgical complications. We used these variables to construct a nomogram for predicting the risk of postoperative surgical complications. At decision curve analysis, the nomogram led to superior outcomes for any decision associated with a threshold probability of >5%. Conclusion: Several clinical predictors have been associated with postoperative surgical complications after PN. We used this information to develop and internally validate a nomogram to predict such risk.
Lingua originaleEnglish
pagine (da-a)93-102
Numero di pagine10
RivistaBJU International
Volume124
Stato di pubblicazionePublished - 2019

All Science Journal Classification (ASJC) codes

  • Urology

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    Simonato, A., Carini, F. M., Schiavina, R., Capitanio, U., Berardinelli, F., Borghesi, M., Campi, R., Marson, F., Larcher, A., Simeone, C., Volpe, A., Antonelli, A., Amparore, D., Falsaperla, M., Furlan, M., Longo, N., Terrone, C., Porreca, A., Di Maida, F., ... Pisano, M. F. (2019). Nomogram for predicting the likelihood of postoperative surgical complications in patients treated with partial nephrectomy: a prospective multicentre observational study (the RECORd 2 project). BJU International, 124, 93-102.