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Design and internal validation of S.I.C.K.: a novel nomogram predicting infectious and hemorrhagic events after

Giorgio Mazzon1, Caterina Gregorio2, Jiehui Zhong3

  • 1Department of Urology, Guangdong Key Laboratories, the first Affiliated Hospital of Guangzhou Medical University, Guangzhou, China - giorgio mazzon83@gmail.com.

Minerva Urology and Nephrology
|July 12, 2023
PubMed

Insights

This study introduces a new nomogram to predict infectious and hemorrhagic complications after percutaneous nephrolithotomy (PCNL). The tool identifies key risk factors to improve patient management and outcomes.

Area of Science:

  • Urology
  • Nephrology
  • Surgical Complications

Background:

  • Percutaneous nephrolithotomy (PCNL) can lead to severe hemorrhagic and infectious complications.
  • Current nomograms for predicting PCNL complications have debatable reliability.
  • A novel nomogram is proposed to enhance the prediction of these adverse events.

Purpose of the Study:

  • To develop and validate a new nomogram for predicting infectious and hemorrhagic complications following PCNL.
  • To identify preoperative risk factors associated with early postoperative complications.
  • To aid clinicians in peri-operative patient management for PCNL.

Main Methods:

  • A multicentric prospective study involving adult patients undergoing standard or mini-PCNL.
  • Data from a previous randomized controlled trial (RCT) was utilized.
  • Risk factors for fever, septic shock, transfusion, and angioembolization were analyzed.

Main Results:

  • 1980 patients were included; 992 (50.1%) had mini-PCNL and 848 (49.9%) had standard PCNL.
  • Overall complication rate was 11.7%, with fever (8.9%), urosepsis (0.7%), transfusion (1.2%), and angioembolization (0.9%).
  • Predictive factors included age, BMI, stone size, hemoglobin, diabetes, eGFR, hypertension, prior PCNL, and hydronephrosis. The model achieved an AUC of 0.73.

Conclusions:

  • A novel nomogram for predicting post-PCNL infections and bleedings has been developed.
  • The nomogram demonstrates good accuracy in identifying patients at risk.
  • This tool can assist clinicians in the peri-operative assessment and management of PCNL patients.
Abstract

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