A Predictive Model of Postnatal Surgical Intervention in Children With Prenatally Detected Congenital Anomalies of the Kidney and Urinary Tract
2019
textabstractThe aim of this study was to identify predictive factors and develop a model to
assess individualized risk of postnatal surgical intervention in patients with antenatal
hydronephrosis. This is a retrospective cohort study of 694 infants with prenatally
detected congenital anomalies of kidney and urinary tract with a median follow-up time
of 37 months. The main event of interest was postnatal surgical intervention. A predictive
model was developed using Cox model with internal validation by bootstrap technique.
Of 694 patients, 164 (24%) infants underwent surgical intervention in a median age of
7.8 months. Predictors of the surgical intervention in the model were: baseline glomerular
filtration rate, associated hydronephrosis, presence of renal damage and the severity
of renal pelvic dilatation. The optimism corrected c statistic for the model was 0.84
(95%CI, 0.82–0.87). The predictive model may contribute to identify infants at high risk
for surgical intervention. Further studies are necessary to validate the model in patients
from other settings.
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