Development and Validation of a Risk Prediction Model for Female Stress Urinary Incontinence in Rural Fujian, China.

Purpose: With China's rapidly aging population and the rising proportion of obese people, an increase in the number of women suffering from urinary incontinence (UI) is to be expected. In order to identify high-risk groups before leakage occurs, we aimed to develop and validate a model to predict the risk of stress UI (SUI) in rural women. Patients and methods: This study included women aged 20-70 years in rural Fujian who participated in an epidemiologic survey of female UI conducted between June and October 2022. Subsequently the data was randomly divided into training and validation sets in a ratio of 7:3. Univariate and multivariate logistic regression analyses were used to identify independent risk factors as well as to further construct a nomogram for risk prediction. Finally, concordance index (C-index), calibration curve and decision curve analysis were applied to evaluate the performance of the predictive models. Results: A total of 5290 rural females were enrolled, of whom 771 (14.6%) had SUI. Age, body mass index (BMI), postmenopausal status, number of vaginal deliveries, vaginal delivery of large infant, constipation and family history of pelvic organ prolapse (POP) and SUI were included in the nomogram. C-index of this prediction model for the training and validation sets was 0.835 (95% confidence interval [CI] = 0.818-0.851) and 0.829 (95% CI = 0.796-0.858), respectively, and the calibration curves and decision analysis curves for both the training and validation sets showed that the model was well-calibrated and had a positive net benefit. Conclusion: This model accurately estimated the SUI risk of rural women in Fujian, which may serve as an effective primary screening tool for the early identification of SUI risk and provide a basis for further implementation of individualized early intervention. Moreover, the model is concise and intuitive, which makes it more operational for rural women with scarce medical resources.

A nomogram model can predict the risk of venous thromboembolism in postoperative patients with gynecological malignancies.

OBJECTIVE: To explore independent factors influencing the risk of lower extremity deep vein thrombosis during the postoperative period in patients with gynecological malignancies by constructing a predictive model. METHODS: In our study, we collected 573 patients with gynecological malignancies in the postoperative period between September 2016 and September 2020, who were divided into a modeling (n = 402) and verification group (n = 171) according to a ratio of 7:3. Univariate and multivariate regression analyses were used to determine independent factors influencing deep vein thrombosis (DVT). A nomogram model was created and a risk score was calculated. RESULTS: Multivariate regression analysis showed that the independent factors affecting DVT among these patients included age, hyperlipidemia, abnormal uterine bleeding, degree of anemia, D-dimer, operation time, and intraoperative blood loss. By incorporating these factors into a nomogram, we determined that the C-index and calibration curve of the two groups both showed that the model distinguishes and fits well. Further comparing between the high- and low-risk groups, we found that the model has favorable predictive performance. CONCLUSION: The predictive nomogram for the risk of DVT in patients with gynecological malignancies in the postoperative period demonstrated good calibration and recognition accuracy. Further independent research is necessary to verify our results.

Internal fixation vs conservative treatment for displaced distal radius fractures: a meta-analysis of randomized controlled trials.

BACKGROUND: The aim of the present study was to compare clinical outcomes of internal fixation and conservative approach in the treatment of displaced distal radius fractures. METHODS: Reports of studies were retrieved from the PubMed, Cochrane Library, EMBASE, BIOSIS, Ovid, CNKI, and Wanfang Data databases, as well as other sources. Methodological quality of the trials was critically assessed, and relevant data were extracted. Review Manager (RevMan) meta-analysis software (version 5.0; Cochrane Collaboration, London, UK) was used for data analysis. RESULTS: A total of 10 randomized controlled trials, which included 653 patients, were eligible for inclusion in the present meta-analysis, 7 of which were in English, and 3 of which were in Chinese. The trials had medium risk of bias. Results of meta-analysis showed that patients undergoing conservative treatment for distal radius fractures had better restoration of pronation (MD=1.80, 95% confidence interval [CI]=0.18-3.42, p=0.03; heterogeneity p=0.17, I2=43%), but shorter restoration of radial length (MD=2.62, 95% CI=1.47-3.76, p<0.00001; heterogeneity p=0.02, I2=73%). Wrist range of motion other than pronation, grip strength, radiographic parameters other than radial length, and rates of complications were not significantly different between the 2 treatments. CONCLUSION: Very few clinical differences were found between results of internal fixation and conservative treatment for displaced distal radius fractures. Best course of of treatment must be determined based on concrete conditions.