Construction And Clinical Application Of The Scoring System For The Prediction Of Sporadic Renalangiomyolipoma Rupture And Hemorrhage

Objective:The objective of this study was to analyze clinical features before tumor rupture and establish a risk prediction scoring system to prevent the occurrence of sporadic renal angiomyolipoma rupture.Methods:The 462 patients with sporadic renal angiomyolipoma admitted to the hospital from January 2012 to April 2019 were collected,including 139 males and 323 females.All the patients were divided into the training set and the validation set.In the training set,single-factor and multi-factor logistic regression were used to analyze the risk factors,and a scoring system was established based on the regression coefficient of each risk factor.In the validation set,the goodness of fit test and ROC were used to evaluate the scoring system.Results:Factors such as symptoms at presentation,tumor size,tumor blood supply,and tumor growth pattern were significant predictors of sporadic renal angiomyolipoma rupture in both the univariate and multivariate analyses;these predictors were included in the scoring system to predict sporadic renal angiomyolipoma rupture.Patients with scores 0-6points are less likely to experience rupture and bleeding and can be followed closely,while patients with scores?7 points require timely intervention because the probability of angiomyolipoma rupture is significantly increased.AUROC of the scoring system in the validation set was 0.893(95%CI:0.779,0.928),Using the Hosmer–Lemeshow method,the?~2 value was 2.916,suggesting that the scoring system fitted well.Conclusion:The scoring system is simple and effective in predicting sporadic angiomyolipoma rupture and hemorrhage.When the score is higher than 6 points,the probability of angiomyolipoma rupture is significantly increased and early intervention is needed.