Construction of Nomogram of the Risk of Infectious Complications after Percutaneous Nephrolithotripsy in Patients with Complex Kidney Stones
Objective To construct and verify Nomogram model for individualized prediction of the risk of infectious complications in patients with complex kidney stones after percutaneous nephrolithotripsy(PCNL).Methods A total of 585 patients with complex kid-ney stones admitted to Cangzhou Hospital of Integrated Traditional and Western Medicine from March 2021 to June 2023 were collected as the study subjects,and divided into modeling group(n=410)and validation group(n=175)at 7∶3.The modeling group was further di-vided into non-complication group(n=342)and complication group(n=68)according to whether there were infectious complications after PCNL surgery.The clinical data were collected and multivariate Logistic regression analysis was applied to determine the factors that affected the occurrence of infectious complications after PCNL surgery in patients with complex kidney stones,and Nomogram model was constructed to predict the occurrence of infectious complications after PCNL surgery in patients with complex kidney stones.Results There were no statistically significant differences in gender,age,body mass index,surgical time,interleukin-6(IL-6)level,C-re-active protein(CRP)level,location and number of stone between the modeling group and the validation group(P＞0.05);compared with the non-complication group,the operation time and stone diameter,the levels of IL-6,CRP in the complication group was higher(t were 5.084,6.727,5.936,7.869,P＜0.05),and the proportions of diabetes and preoperative urinary tract infection were higher(x2 were 12.520,35.117,P＜0.05).The results of multivariate Logistic regression analysis showed that operation time(OR=1.077),stone diameter(OR=1.303),IL-6(OR=1.334),CRP(OR=1.381),diabetes(OR=3.288),preoperative urinary tract infection(OR=5.458)were all independent risk factors for infection complications after PCNL surgery in patients with complex kidney stones(P＜0.05).The area under the curve for the modeling group and validation group were 0.919(95％CI:0.889-0.949)and 0.939(95％CI:0.882-0.996),respectively.The results of the Hosmer-Limeshow goodness of fit test showed that the modeling group x2=5.484,P=0.705;validation group x2=10.101,P=0.258.Conclusion Operation time,stone diameter,IL-6,CRP,diabetes and preoperative urinary tract infection are independent risk factors for infectious complications after PCNL in patients with complex kidney stones.The Nomogram model based on these factors has high degree of discrimination and consistency.
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