PD10-05 A MULTI-CENTER RANDOMIZED CONTROLLED TRIAL OF AMBULATORY VERSUS INPATIENT PERCUTANEOUS NEPHROLITHOTOMY
Notice bibliographique
Résumé
You have accessJournal of UrologyStone Disease: Surgical Therapy (including ESWL) II (PD10)1 May 2024PD10-05 A MULTI-CENTER RANDOMIZED CONTROLLED TRIAL OF AMBULATORY VERSUS INPATIENT PERCUTANEOUS NEPHROLITHOTOMY Gregory Hosier, Darren Beiko, Heiko Yang, Wilson Sui, David Bayne, Marshall Stoller, and Thomas Chi Gregory HosierGregory Hosier , Darren BeikoDarren Beiko , Heiko YangHeiko Yang , Wilson SuiWilson Sui , David BayneDavid Bayne , Marshall StollerMarshall Stoller , and Thomas ChiThomas Chi View All Author Informationhttps://doi.org/10.1097/01.JU.0001008748.59024.cb.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Ambulatory percutaneous nephrolithotomy (PCNL) has been proposed as a means to speed patient recovery, decrease hospital stay time, and decrease cost compared to inpatient PCNL. Studies evaluating ambulatory PCNL have utilized highly selective selection criteria that preclude the vast majority of PCNL candidates. The goal of our study was to perform a high quality randomized controlled trial of ambulatory versus inpatient PCNL in a representative patient population including those with large stones (>4 cm), BMI>30, and ASA>2. METHODS: This was a multi-center, non-inferiority, randomized controlled trial of ambulatory versus inpatient PCNL at University of Manitoba and University of California, San Francisco. Patients were randomized prior to surgery stratified for ASA, BMI, stone size, and study site. Primary outcomes were complication and readmission rates within 4 weeks of surgery. Secondary outcomes were stone free rate (CT scan 4 weeks after surgery), quality of life (using WisQOL), and return to work time. RESULTS: Of 62 patients (32 ambulatory and 30 inpatient), mean age was 71, 48% were BMI>30, 41% were ASA 3/4, and 31% had stone size >4cm. There was no difference in our primary outcome of complication rate between those who underwent ambulatory (3%) and inpatient PCNL (10%, p=0.33, Table 1). Readmission rate within 4 weeks was not different between the ambulatory (3%) and inpatient group (4%, p=1). Stone free rate was not different between the ambulatory (72%) and inpatient group (73%, p=1). Mean recovery time in hospital after surgery was 2-3 hours in the ambulatory group versus 1 day in the inpatient group. The rate of patients who were able to return to work within 1 week was not different between the ambulatory group (88%) versus the inpatient group (80%, p=0.5). In those randomized to the ambulatory group, 3 (13%) required cross-over to the inpatient group for obstructive sleep apnea monitoring, elevated potassium monitoring, or surgical monitoring. CONCLUSIONS: Ambulatory PCNL has similar complication rates, stone free rates, and readmission rates compared to those who undergo inpatient PCNL. Our results support the use of ambulatory PCNL in patients with BMI>30, ASA>2, and stone size >4 cm who have typically been excluded from consideration for ambulatory PCNL in the past. Source of Funding: This work was supported in part by the 2022 Urology Care Foundation Research Scholar Award Program and the Endourological Society Raju Thomas, MD Award © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e187 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Gregory Hosier More articles by this author Darren Beiko More articles by this author Heiko Yang More articles by this author Wilson Sui More articles by this author David Bayne More articles by this author Marshall Stoller More articles by this author Thomas Chi More articles by this author Expand All Advertisement PDF downloadLoading ...
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 machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,005 | 0,008 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,003 | 0,004 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,002 | 0,002 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,003 | 0,004 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,017 | 0,001 |
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 source (Gemma direct ou Codex distillé), 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 ».