Development of a prediction model for risk of breakthrough urinary tract infection in children with primary vesicoureteral reflux
Abstract
Background Many factors influence the risk of breakthrough urinary tract infection (BTUTI) in children with primary vesicoureteral reflux (VUR). Distal ureteral diameter ratio (UDR) and VUR index (VURx) have been shown in studies as predictors of BTUTI. We aimed to establish a predictive model through selecting voiding cystourethrography (VCUG)-related parameters in combination with clinical parameters for BTUTI in children with primary VUR. Methods A retrospective cohort analysis was conducted on the clinical characteristics and VCUG-related parameters of patients with primary VUR. Univariable and multivariable analyses were performed to identify independent predictors and develop a model for predicting the probability of BTUTI. We compared our model against two other metrics for predicting BTUTI: the distal UDR and the VURx. The area under the receiver operating characteristic (ROC) curve (AUC), calibration curve, and decision curve analysis (DCA) were used to evaluate the predictive performance of the model. Results A total of 193 patients were included in this study. Based on the results of univariable and multivariable analyses, three variables of sex (female) [odds ratio (OR): 3.39; 95% confidence interval (CI): 1.57–7.33], high-grade VUR (OR: 2.27; 95% CI: 0.98–5.25), and ureterovesical junction diameter of ureter (UVJ diameter) (OR: 5.85; 95% CI: 1.81–18.92) were used to create a prediction model and a nomogram. The AUCs for our model, the UDR, and the VURx in…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 193 participants or records.
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