Nomograms for Predicting the Risk of SIRS and Urosepsis after Uroscopic Minimally Invasive Lithotripsy

Area of Science:

• Urology
• Infectious Diseases
• Medical Informatics

Background:

• Urosepsis is a serious complication following uroscopic minimally invasive lithotripsy.
• Accurate prediction of urosepsis risk is crucial for patient management and outcomes.

Purpose of the Study:

• To identify independent risk factors for developing urosepsis after percutaneous nephrolithotripsy (PCNL) or ureteroscopic lithotripsy (URL).
• To develop and validate a predictive nomogram for postoperative urosepsis risk in patients undergoing these procedures.

Main Methods:

• Retrospective analysis of 236 patients who underwent PCNL or URL between January 2018 and December 2019.
• Logistic regression analysis to identify independent predictors of SIRS and urosepsis.
• Development of nomograms to predict the probability of SIRS and urosepsis.

Main Results:

• Postoperative SIRS occurred in 27.12% and urosepsis in 7.20% of patients.
• Independent predictors for SIRS included positive preoperative urine culture, procalcitonin (PCT), C-reactive protein (CRP), and neutrophil ratio.
• PCT and CRP were independent predictors of urosepsis.
• Nomograms showed high accuracy (C-index 0.884 for SIRS, 0.941 for urosepsis).

Conclusions:

• Developed nomograms effectively predict SIRS and urosepsis risk after uroscopic minimally invasive lithotripsy.
• The nomogram facilitates early diagnosis and rational treatment strategies for at-risk patients.
• This tool aids in personalized risk assessment for patients undergoing kidney stone procedures.