Laparoscopic Radical Simple Nephrectomy Lesser or Greater Than One Day Duration of Hospital Stay Predictor

Univariate logistic regression analysis in the design group for duration of hospital stay lesser or greater than one day (Table 4) identified simple nephrectomy, hypertension and planned morcellation extraction incision as significant predictors of a duration of hospital stay of greater than one day.

Multiple logistic regression analysis (Table 4) identified hypertension and planned extraction incision as independent significant predictors of a duration of hospital stay greater than one day. This analysis identified the appropriate weighting for parameters in the design of a linear regression prediction algorithm. Simple nephrectomy and planned extraction incision were utilized in the final model to optimize accuracy. The addition of hypertension did not increase model accuracy and, thus, was not used. This may be due to the fact that patients with hypertension that stayed greater than one day had one of the other factors concurrently.

The equation for the lesser or greater than one day duration of hospital stay prediction model is:

1 Day score = (Simple or radical X 6) — (0.5 X Incision type) Key:

Type of nephrectomy: Simple = 2, radical = 1

Incision type: Morcellated = 0, Pfannenstiel, infraumbilical, McBurney's,

Gibson = 1; flank incision = 2

If the score is greater than 5, then a duration of hospital stay of greater than one day is predicted. If the score is lesser than 5, a duration of hospital stay of less than one day is predicted. The model accuracy in the design group was 73% (receiver operating characteristic 0.7) and in the test group was 97% (receiver operating characteristic 0.8) as shown in Table 7.

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