Predicting catheter removal in peritoneal dialysis peritonitis patients visiting the emergency department: a multivariable logistic regression and decision tree analysis.

IF 2.4 3区医学 Q2 SURGERY

Updates in Surgery Pub Date : 2025-05-25 DOI:10.1007/s13304-025-02256-4

Cheng-Chih Chang, Cheng-Chi Liu, Ching-Chuan Hsieh, David Ming Then Tsai, Shih-Jiun Lin, Da-Wei Lin, Ya-Hsueh Shih, Yung-Chien Hsu, Chun-Liang Lin

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Abstract

Peritonitis is a debilitating complication of peritoneal dialysis (PD). Identifying high-risk patients requiring PD catheter removal based on early information in the emergency room (ER) is critical. This cross-sectional study included 518 PD patients who visited the ER in the Chang Gung Memorial Hospital, Chia-Yi branch between 2002 and 2018. Among the 518 PD patients, 31 (6%) required PD catheter removed during the visit. Decision tree analysis, incorporating five key factors (neutrophil count, CRP, age, sodium, and albumin), identified 16 terminal nodes (TNs), with four higher risk groups (> 20%): lower neutrophils with lower CRP and younger age (TN1), lower neutrophils with higher CRP (TN4), higher neutrophils with moderate age and lower albumin (TN14), and high neutrophils with older age (TN16). Decision tree analysis effectively predicts the optimal timing for catheter removal in PD peritonitis patients. Clinically, this approach helps reduce mortality resulting from delayed catheter removal.

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预测急诊腹膜透析腹膜炎患者的导管拔除：多变量logistic回归和决策树分析。

腹膜炎是腹膜透析（PD）的一种衰弱并发症。根据急诊室（ER）的早期信息识别需要PD导管拔除的高危患者至关重要。这项横断面研究包括2002年至2018年间在长庚纪念医院嘉义分院就诊的518名PD患者。518例PD患者中，31例（6%）患者需要在就诊期间拔除PD导管。结合五个关键因素（中性粒细胞计数、CRP、年龄、钠和白蛋白）的决策树分析，确定了16个终末淋巴结（tnn），其中有4个高危组（> 20%）：低中性粒细胞伴低CRP和年轻（TN1），低中性粒细胞伴高CRP (TN4)，高中性粒细胞伴中等年龄和低白蛋白（TN14），高中性粒细胞伴老年（TN16）。决策树分析可有效预测腹膜炎患者的最佳拔管时机。临床上，这种方法有助于降低延迟拔管导致的死亡率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Updates in Surgery Medicine-Surgery

CiteScore

4.50

自引率

7.70%

发文量

208

期刊介绍： Updates in Surgery (UPIS) has been founded in 2010 as the official journal of the Italian Society of Surgery. It’s an international, English-language, peer-reviewed journal dedicated to the surgical sciences. Its main goal is to offer a valuable update on the most recent developments of those surgical techniques that are rapidly evolving, forcing the community of surgeons to a rigorous debate and a continuous refinement of standards of care. In this respect position papers on the mostly debated surgical approaches and accreditation criteria have been published and are welcome for the future. Beside its focus on general surgery, the journal draws particular attention to cutting edge topics and emerging surgical fields that are publishing in monothematic issues guest edited by well-known experts. Updates in Surgery has been considering various types of papers: editorials, comprehensive reviews, original studies and technical notes related to specific surgical procedures and techniques on liver, colorectal, gastric, pancreatic, robotic and bariatric surgery.