Nomogram predicts risk score and likehood of orchiectomy in patients with testicular torsion: a multicenter retrospective study.

IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY
Jingmin Zhang, Zihong Wang, Haoyuan Zhang, Zikun Shao, Wenjie Wang, Ying Qiu, Haosen Shen, Hongcheng Song, Xianghui Xie
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引用次数: 0

Abstract

Purpose: Testicular torsion is a prevalent scrotal emergency associated with a significant risk of testicular loss, and there is no reliable scoring system available to assess the likelihood of orchiectomy following testicular torsion.

Methods: Clinical characteristics and surgical data of patients with testicular torsion from January 2015 to May 2024 were gathered from National Center for Children's Health (NCCH) and the Children's Hospital of Capital Institute of Pediatrics (CIPCH). Independent risk variables for testicular resection were evaluated by logistic regression analyses, leading to the establishment of a nomogram. The performance of the nomogram was assessed and validated using AUC, C-index, calibration curves, and DCA. Patients were classified based on their risk score obtained from the nomogram for clinical application.

Results: A total of 387 patients were included. Risk factors were identified by multifactorial analysis: symptoms duration, testicular blood flow, degree of torsion, and cryptorchidism. A nomogram exhibits an area under the ROC curve of 0.9305 and a C-index of 0.9310. A scoring system was developed accordingly, categorising patients into four groups; 88.7% of patients in the super-low and low-risk categories preserved their testes, while 78.6% in the super-high and high-risk categories underwent testicular resection.

Conclusion: The strong concordance between predicted and actual outcomes suggests the model's utility in clinical decision-making. The nomogram demonstrates robust calibration and differentiation capabilities.

Nomogram预测风险评分和睾丸扭转患者切除睾丸的可能性:一项多中心回顾性研究。
目的:睾丸扭转是一种常见的阴囊急症,与睾丸丧失的显著风险相关,目前还没有可靠的评分系统来评估睾丸扭转后睾丸切除术的可能性。方法:收集2015年1月至2024年5月国家儿童卫生中心(NCCH)和首都儿科研究所儿童医院(CIPCH)睾丸扭转患者的临床特征和手术资料。通过逻辑回归分析评估睾丸切除术的独立风险变量,从而建立nomogram。采用AUC、c指数、校准曲线和DCA对nomogram进行评价和验证。根据nomogram风险评分对患者进行分类,以供临床应用。结果:共纳入387例患者。通过多因素分析确定危险因素:症状持续时间、睾丸血流量、扭转程度和隐睾。nomogram的ROC曲线下面积为0.9305,C-index为0.9310。据此开发了一个评分系统,将患者分为四组;88.7%的超低、低危患者保留了睾丸,而78.6%的超高、高危患者行了睾丸切除术。结论:预测结果与实际结果具有较强的一致性,说明该模型在临床决策中的实用性。图显示稳健的校准和区分能力。
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来源期刊
World Journal of Urology
World Journal of Urology 医学-泌尿学与肾脏学
CiteScore
6.80
自引率
8.80%
发文量
317
审稿时长
4-8 weeks
期刊介绍: The WORLD JOURNAL OF UROLOGY conveys regularly the essential results of urological research and their practical and clinical relevance to a broad audience of urologists in research and clinical practice. In order to guarantee a balanced program, articles are published to reflect the developments in all fields of urology on an internationally advanced level. Each issue treats a main topic in review articles of invited international experts. Free papers are unrelated articles to the main topic.
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