Application of the postnatal urinary tract dilation classification system to predict the need for surgical intervention among neonates and young infants
Purpose The aim of this study was to validate the postnatal urinary tract dilation (UTD) classification system by correlating it with the need for surgical intervention. Methods Young infants who underwent ultrasound (US) examinations for prenatal hydronephrosis were retrospectively identified. The...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Society of Ultrasound in Medicine
2023-01-01
|
| Series: | Ultrasonography |
| Subjects: | |
| Online Access: | http://www.e-ultrasonography.org/upload/usg-22035.pdf |
| _version_ | 1797960063273402368 |
|---|---|
| author | Jisun Hwang Pyeong Hwa Kim Hee Mang Yoon Sang Hoon Song Ah Young Jung Jin Seong Lee Young Ah Cho |
| author_facet | Jisun Hwang Pyeong Hwa Kim Hee Mang Yoon Sang Hoon Song Ah Young Jung Jin Seong Lee Young Ah Cho |
| author_sort | Jisun Hwang |
| collection | DOAJ |
| description | Purpose The aim of this study was to validate the postnatal urinary tract dilation (UTD) classification system by correlating it with the need for surgical intervention. Methods Young infants who underwent ultrasound (US) examinations for prenatal hydronephrosis were retrospectively identified. The kidney units (KUs; right, left, or bilateral) were graded from UTD P0 (very low risk) to P3 (high risk) based on seven US criteria from the UTD system. Surgery-free survival curves were constructed using the Kaplan-Meier method. Univariable and multivariable Cox proportional-hazards regression analysis clustered by patients was performed. Interobserver agreement was analyzed using the weighted kappa coefficient. Results In total, 504 KUs from 336 patients (mean age, 18.3±15.9 days; range, 1 to 94 days; males, n=276) were included, with a median follow-up of 24.2 months. Fifty-eight KUs underwent surgical intervention. Significant differences were observed among the Kaplan-Meier curves stratified into UTD groups (P<0.001). The presence of anterior-posterior renal pelvic diameter ≥15 mm (hazard ratio [HR], 8.602; 95% confidence interval [CI], 1.558 to 43.065), peripheral calyceal dilation (HR, 8.190; 95% CI, 1.558 to 43.065), ureteral dilation (HR, 2.619; 95% CI, 1.274 to 5.380), parenchymal thickness abnormality (HR, 3.371; 95% CI, 1.574 to 7.223), bladder abnormality (HR, 12.209; 95% CI, 3.616 to 41.225) were significantly associated with the occurrence of surgery. The interobserver agreement was moderate to almost perfect agreement for US features (κ=0.564-0.898) and substantial for final UTD grades (κ=0.716). Conclusion The UTD classification system is reliable and appropriately stratifies the risk of surgical intervention. |
| first_indexed | 2024-04-11T00:40:21Z |
| format | Article |
| id | doaj.art-70fed06e111a43b08f5046b30d44bd95 |
| institution | Directory Open Access Journal |
| issn | 2288-5919 2288-5943 |
| language | English |
| last_indexed | 2024-04-11T00:40:21Z |
| publishDate | 2023-01-01 |
| publisher | Korean Society of Ultrasound in Medicine |
| record_format | Article |
| series | Ultrasonography |
| spelling | doaj.art-70fed06e111a43b08f5046b30d44bd952023-01-06T07:21:45ZengKorean Society of Ultrasound in MedicineUltrasonography2288-59192288-59432023-01-0142113614610.14366/usg.220351632Application of the postnatal urinary tract dilation classification system to predict the need for surgical intervention among neonates and young infantsJisun Hwang0Pyeong Hwa Kim1Hee Mang Yoon2Sang Hoon Song3Ah Young Jung4Jin Seong Lee5Young Ah Cho6 Department of Radiology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaPurpose The aim of this study was to validate the postnatal urinary tract dilation (UTD) classification system by correlating it with the need for surgical intervention. Methods Young infants who underwent ultrasound (US) examinations for prenatal hydronephrosis were retrospectively identified. The kidney units (KUs; right, left, or bilateral) were graded from UTD P0 (very low risk) to P3 (high risk) based on seven US criteria from the UTD system. Surgery-free survival curves were constructed using the Kaplan-Meier method. Univariable and multivariable Cox proportional-hazards regression analysis clustered by patients was performed. Interobserver agreement was analyzed using the weighted kappa coefficient. Results In total, 504 KUs from 336 patients (mean age, 18.3±15.9 days; range, 1 to 94 days; males, n=276) were included, with a median follow-up of 24.2 months. Fifty-eight KUs underwent surgical intervention. Significant differences were observed among the Kaplan-Meier curves stratified into UTD groups (P<0.001). The presence of anterior-posterior renal pelvic diameter ≥15 mm (hazard ratio [HR], 8.602; 95% confidence interval [CI], 1.558 to 43.065), peripheral calyceal dilation (HR, 8.190; 95% CI, 1.558 to 43.065), ureteral dilation (HR, 2.619; 95% CI, 1.274 to 5.380), parenchymal thickness abnormality (HR, 3.371; 95% CI, 1.574 to 7.223), bladder abnormality (HR, 12.209; 95% CI, 3.616 to 41.225) were significantly associated with the occurrence of surgery. The interobserver agreement was moderate to almost perfect agreement for US features (κ=0.564-0.898) and substantial for final UTD grades (κ=0.716). Conclusion The UTD classification system is reliable and appropriately stratifies the risk of surgical intervention.http://www.e-ultrasonography.org/upload/usg-22035.pdfhydronephrosisultrasonographyinfantprognosisreproducibility of results |
| spellingShingle | Jisun Hwang Pyeong Hwa Kim Hee Mang Yoon Sang Hoon Song Ah Young Jung Jin Seong Lee Young Ah Cho Application of the postnatal urinary tract dilation classification system to predict the need for surgical intervention among neonates and young infants Ultrasonography hydronephrosis ultrasonography infant prognosis reproducibility of results |
| title | Application of the postnatal urinary tract dilation classification system to predict the need for surgical intervention among neonates and young infants |
| title_full | Application of the postnatal urinary tract dilation classification system to predict the need for surgical intervention among neonates and young infants |
| title_fullStr | Application of the postnatal urinary tract dilation classification system to predict the need for surgical intervention among neonates and young infants |
| title_full_unstemmed | Application of the postnatal urinary tract dilation classification system to predict the need for surgical intervention among neonates and young infants |
| title_short | Application of the postnatal urinary tract dilation classification system to predict the need for surgical intervention among neonates and young infants |
| title_sort | application of the postnatal urinary tract dilation classification system to predict the need for surgical intervention among neonates and young infants |
| topic | hydronephrosis ultrasonography infant prognosis reproducibility of results |
| url | http://www.e-ultrasonography.org/upload/usg-22035.pdf |
| work_keys_str_mv | AT jisunhwang applicationofthepostnatalurinarytractdilationclassificationsystemtopredicttheneedforsurgicalinterventionamongneonatesandyounginfants AT pyeonghwakim applicationofthepostnatalurinarytractdilationclassificationsystemtopredicttheneedforsurgicalinterventionamongneonatesandyounginfants AT heemangyoon applicationofthepostnatalurinarytractdilationclassificationsystemtopredicttheneedforsurgicalinterventionamongneonatesandyounginfants AT sanghoonsong applicationofthepostnatalurinarytractdilationclassificationsystemtopredicttheneedforsurgicalinterventionamongneonatesandyounginfants AT ahyoungjung applicationofthepostnatalurinarytractdilationclassificationsystemtopredicttheneedforsurgicalinterventionamongneonatesandyounginfants AT jinseonglee applicationofthepostnatalurinarytractdilationclassificationsystemtopredicttheneedforsurgicalinterventionamongneonatesandyounginfants AT youngahcho applicationofthepostnatalurinarytractdilationclassificationsystemtopredicttheneedforsurgicalinterventionamongneonatesandyounginfants |