Construction and clinical application of a risk assessment system for retrograde intrarenal sur-gery complicated with urosepsis
Objective To establish a risk assessment system for retrograde intrarenal surgery to assess the risk of postoperative complications of urosepsis.Methods The clinical data of 244 pa-tients who underwent RIRS treatment in Changsha Central Hospital from October 2021 to February 2022 were selected.The literature on the risk factors of urosepsis complicated by RIRS was searched at home and abroad,and the search time was from the establishment of the database to December 2021,the case data of patients receiving RIRS in the retrieval literature were collected,the risk factors of urosepsis complicated by RIRS were screened by Meta-analysis,the risk assessment system for urosep-sis complicated by RIRS was constructed(FURSS)after RIRS,and the clinical application value of the evaluation system was verified by using the receiver operating characteristic(ROC)curve.Results Seven risk factors[gender(female),operation time ≥60 min,diabetes,positive preoperative urine culture,stone diameter ≥1 cm,infectious stones and pyuria]were associated with the risk of urosep-sis after RIRS.According to the diagnostic criteria for urosepsis,the rate of postoperative urosepsis was approximately 5.3％(13/244).According to the risk scoring system,45 patients with preopera-tive score＞6.5 scores,of which 11 patients developed postoperative urosepsis.The area under the ROC curve was 0.890(95％CI:0.818-0.963,P＜0.001),and when the score was 6.5 scores,the Youden index was the highest,with a sensitivity of 84.6％and a specificity of 85.3％.Conclusions The FURSS established in this institute has good predictive value for the postoperative triggering of urosepsis in RIRS,and when the patient's preoperative comprehensive score is greater than 6.5 scores,the risk of postoperative urosepsis is higher.
NETL
NSTL
万方数据
维普
