Risk factors and predictive model of complicating urosepsis after percutaneous nephrolithotripsy
10.3969/j.issn.1671-8348.2024.02.005
- VernacularTitle:经皮肾镜碎石术后并发尿源性脓毒血症的危险因素及预测模型研究
- Author:
Dawei ZHANG
1
;
Gaoping CAI
;
Yangyang TAN
;
Yuxiang LI
;
Cheng YANG
;
Bin ZHANG
;
Xukai YANG
Author Information
1. 甘肃省中心医院泌尿外科,兰州 730000
- Keywords:
urinary calculi;
percutaneous nephrolithotripsy;
urinary sepsis;
risk factors;
predictive model
- From:
Chongqing Medicine
2024;53(2):180-187
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the risk factors of complicating urogenic sepsis after percutaneous nephrolithotripsy(PCNL)and construct a nomogram prediction model.Methods The data of 291 patients with stage 1 PCNL in 940 Hospital of Joint Logistics Support Force from October 2016 to October 2021 were retrospectively analyzed.The patients were divided into the sepsis group and non-sepsis group according to whether complicating urogenic sepsis after operation.The general data,stone-related data,operation-related data and laboratory detection related data were included.The independent risk factors were screened by the univariate and multivariate logistic regression analysis,and the nomogram prediction model was constructed.Results The results of univariate and multivariate logistic regression analysis showed that age≥60 years old(OR=6.438,95％CI:1.548-26.769),urinary leukocyte 3+(OR=5.651,95％CI:1.614-31.766),urinary nitrite positive(OR=7.117,95％CI:1.190-42.561),operation time≥90 min(OR=4.626,95％CI:1.137-18.817)and perfusion volume 30 L(OR=3.312,95％CI:1.090-10.061)were the independent risk factors of postoperative complicating urogenic sepsis.C-index of the constructed nomogram prediction model in the modeling samples was 0.937,the calibrated C-index was 0.914,and the model predictive efficien-cy was good.Conclusion Age ≥60 years old,urinary leukocyte 3+,urinary nitrite positive,operation time 90 min and perfusion volume ≥30 L are the independent risk factors for complicating urogenic sepsis after PCNL;the constructed nomogram prediction model has a good predictive efficiency for the occurrence of post-operative urogenic sepsis.
