Predictors of health‐related quality of life recovery following laparoscopic simple, radical and donor nephrectomy
Notice bibliographique
Résumé
Study Type – Therapy (case series) Level of Evidence 4 What’s known on the subject? and What does the study add? Despite laparoscopy becoming the favoured approach for nephrectomy, there is very little research into the predictors of recovery following surgery and return of health‐related quality of life following laparoscopic nephrectomy. The current study demonstrates that patients who are younger, have lower BMI, have more active lifestyles and those who are not donating a kidney recover more quickly following surgery. Older, more obese, less active patients, and those donating a kidney take longer to recover from surgery. OBJECTIVES To objectively quantify the recovery of health‐related quality of life (HRQL) in patients undergoing laparoscopic nephrectomy. To determine which factors are predictive of a more expedited recovery. MATERIALS AND METHODS Patient recovery was prospectively measured among patients undergoing laparoscopic simple ( n = 12), radical ( n = 42) and donor ( n = 95) nephrectomy. All procedures were performed using a 3‐ or 4‐trocar, transperitoneal fully‐laparoscopic technique with intact specimen extraction using impermeable sacs for simple and radical nephrectomy, and hand extraction for donor nephrectomy. Postoperative recovery and quality of life were measured using the Postoperative Recovery Scale (PRS) administered preoperatively, immediately postoperatively and as an outpatient at 4, 8, 12, and 16 weeks postoperatively. ANOVA and Pearson’s χ 2 tests were performed on demographic data. Multivariate logistic regression analysis was used to calculate odds ratios for factors predictive of recovery. RESULTS Statistically significant differences were found at baseline for age ( P = 0.02), gender ( P < 0.01), body mass index (BMI; P = 0.03), surgical side ( P < 0.01) and activity‐based lifestyle ( P = 0.04) across the three groups. Minimal adverse events were seen. Factors predictive of expedited recovery include age < 50 years (OR: 2.1, P < 0.01), body‐mass index (BMI) < 30 kg/m 2 (OR: 1.7, P < 0.01), active lifestyles (OR: 1.3, P < 0.01) and those patients undergoing nephrectomy for benign or malignant indications rather than for organ donation (OR: 1.4, P < 0.01). There was a significant delay in the donor group vs the non‐donor group with respect to the median number of days both groups took to recover 75% and 90% of their baseline PRS scores (11 days, P = 0.02; 20 days, P = 0.02, respectively). CONCLUSIONS Predictive factors of recovery from laparoscopic nephrectomy include age, BMI, lifestyle and surgical indication. Differences between HRQL recovery following donor vs non‐donor laparoscopic nephrectomy are significant, and suggest the possible interplay of underlying psychological factors.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».