Clinical prediction model of urogenic sepsis after percutaneous nephrolithotomy
Objective To establish a predictive model for risk factors causing urogenital sepsis after percutaneous nephrolithotomy(PCNL).Methods The clinical data of 220 patients with kidney stones,upper ureteral stones who underwent PCNL in our department from August 2018 to August 2022 were retrospectively analyzed and divided into urogenic sepsis group(21 cases)and non-urogenic sepsis group(199 cases)based on whether they progressed to sepsis after surgery,and their influencing factors such as age,gender,body mass index(BMI),history of diabetes,urinary routine and urine culture were analyzed univariately and multifactorially,respectively.Corresponding line graph prediction models were established.Results The results of multivariate logistic regression analysis showed that the independ-ent risk factors for postoperative progression to sepsis were history of diabetes mellitus(OR=7.64,P=0.002),urine culture(OR=2.97,P=0.021),CT value of hydronephrosis(OR=4.52,P=0.013),num-ber of stones(OR=4.25,P=0.032),and deerstalker-shaped stones(OR=3.70,P=0.036).The AUC of the prediction model was 0.919,as suggested by the Hosmer-Lemeshow test,revealing a prediction mod-el with good discrimination and calibration(x2=4.069,P=0.851).Conclusions History of diabetes mel-litus,midstream urine culture,CT value of hydronephrosis,number of stones,and antler-shaped stones are independent risk factors for urogenital sepsis after PCNL.
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