Create a predictive model for neurogenic bladder patients: upper urinary tract damage predictive nomogram

Abstract

Objective: To create a nomogram to evaluate the risk of upper urinary tract damage (UUTD) in patients with neurogenic bladder (NGB)

Methods: A retrospective analysis was conducted on 301 patients with NGB who were admitted to certain hospitals. Data collected included clinical symptoms, patients’ characteristics, laboratory parameters, imaging findings, and urodynamic parameters. The least absolute shrinkage and selection operator（LASSO）regression model was used to optimise the selection of predictors. Multivariate logistic regression analysis was performed to develop a UUTD risk predictive model. Validation was performed by bootstrap.

Results: The predictors included in the nomogram included sex, duration of disease, history of UTI, bladder compliance, and fecal incontinence. The model presented good discrimination with a C-index value of 0.796 (95% confidence interval: 0.74896–0.84304) and good calibration. The C-index value of the interval validation was 0.7872112. The results of decision curve analysis (DCA) demonstrated that the UUTD-risk predictive nomogram was clinically useful.

Conclusion: The nomogram incorporating the sex, duration of disease, history of UTI, bladder compliance, and fecal incontinence could be an important tool of UUTD risk prediction in NGB patients.

Keywords:

• Upper urinary tract damage
• neurogenic bladder
• predictive model
• nomogram

Acknowledgements

The authors thank Chuanguo Xiao from C.G. Xiao Hospital for assisting in collecting data.

Author’s contribution

Wenzhi Cai is responsible for the design and revision of papers. Wenqiang Wang writing the paper, responsible for statistics, collects data from Nanfang Hospital of Southern Medical University, Peking University Shenzhen Hospital, C.G. Xiao Hospital. Hengying Fang collects data from the Third Affiliated Hospital of Sun Yat-sen University, the First People's Hospital of Foshan and Guangdong Work Injury Rehabilitation Hospital. Peng Xie assist statistics, collects data from Nanchong Central Hospital. Qunduo Cao assist Wenqiang Wang in collecting data from Shenzhen Hospital of Peking University. Ling He assist Wenqiang Wang in collecting data from Southern Hospital. Data entry by Wenqiang Wang and Peng Xie.

Disclosure statement

No potential conflict of interest was reported by the authors.

The ethics committees

The study was granted ethical approval by the Ethics Committees of Shenzhen Hospital, Southern Medical University on 5 March 2018 (no. SZYYEC2018R001).

Additional information

Funding

This work was supported by grants from the Natural Science Foundation of Guangdong Province China (No. 2016A030313623), and the Breeding Project of Clinical Research of Southern Medical University (No. LC2016PY060).