Construction and Validation of a Risk Prediction Model for Postoperative Urinary Retention in Lung Cancer Patients.

Wei Zheng,Yicheng Liang,Xu Zhang,Xu Zheng,Yan Liu,Yushun Gao

doi:10.1155/2022/2227629

Abstract

Indwelling catheter is a routine procedure in surgical patients. Studies have shown that prolonged indwelling urinary catheterization increases the risk of postoperative urinary tract infection. Although early removal of the urinary catheter after operation can reduce the risk of postoperative urinary symptoms and tract infections, it may lead to postoperative anesthetic dysuria. Therefore, this study investigates the urinary retention and related risk factors in patients after thoracoscopic lobectomy under general anesthesia. The clinical data of 214 patients who underwent thoracoscopic lobectomy in the Department of Thoracic Surgery of a tertiary class A cancer hospital in Beijing from July 2020 to April 2021 were collected. A risk prediction model was established by logistic regression analysis, and the prediction effect was determined using the area under the receiver operating characteristic (ROC) curve. The incidence of indwelling catheter after thoracoscopic lobectomy was 44.8% (96/214). Sex (OR = 21.102, 95% CI: 2.906–153.239, P=0.003), perception of shame (OR = 74.256, 95% CI: 6.171–893.475, P=0.001), age (OR = 1.095, 95% CI: 1.014–1.182, P=0.021), and bed rest time (OR = 1.598, 95% CI: 1.263–2.023, P < 0.021) were the factors influencing urinary retention after thoracoscopic lobectomy. This model can effectively predict the occurrence of postoperative urinary retention in patients with lung cancer and help medical staff to intervene effectively before the onset of urinary retention, which provides reference for preventive treatment and nursing intervention.

Highlights

Lung cancer is a malignant tumor originating from the lungs, trachea, and bronchi [1, 2]
Previous studies have shown that the incidence of postoperative urinary retention is 5–70%, and the related risk factors have been identified in several surgical subspecialties [9–11]
Using the rms package of R language, a predictive model was built from the multivariate regression analysis and a nomogram based on the regression coefficients of each group. pROC package was used to plot receiver operating characteristic (ROC) curves for correction. e construction of the nomogram in this study was performed in the R software

Summary

Introduction

Lung cancer is a malignant tumor originating from the lungs, trachea, and bronchi [1, 2]. Urinary retention in lung cancer refers to a condition in which a bladder is filled with urine but cannot be excreted [5, 6]. Surgical patients usually have perioperative indwelling catheters, mainly to observe the intraoperative urine volume, evaluate urine volume, control intraoperative infusion volume, and prevent postoperative anesthetic dysuria [7]. Lung cancer patients usually do not have indwelling catheters before surgery, but after returning to the ward. There are no uniform clinical guidelines for perioperative indwelling catheter time. Instead, it is usually based on the clinician’s experience, patients’ conditions, surgical type, and perioperative factors. Previous studies have shown that the incidence of postoperative urinary retention is 5–70%, and the related risk factors have been identified in several surgical subspecialties [9–11]

Methods

Results

Conclusion