Related Experiment Video
Updated: Jul 12, 2025
07:03
Standardized Colon Ascendens Stent Peritonitis in Rats - a Simple, Feasible Animal Model to Induce Septic Acute Kidney Injury
Published on: February 15, 2022
1.5K
Development and validation of a predictive model for post-percutaneous nephrolithotomy urinary sepsis: a multicenter
Leibo Wang1,2, Daobing Li3, Wei He1,2
1Department of Surgery, Orthopedic Hospital of Guizhou, Guiyang, China.
Minerva Urology and Nephrology
|October 23, 2023
Summary
A new nomogram model predicts urogenital sepsis after percutaneous nephrolithotomy (PCNL). Key risk factors include positive urine culture, longer operation time, and residual stones, aiding urologists in preoperative planning.
Area of Science:
- Urology
- Nephrology
- Infectious Disease
Background:
- Urogenital sepsis is a significant complication following percutaneous nephrolithotomy (PCNL).
- Identifying predictive factors for sepsis is crucial for patient management.
Purpose of the Study:
- To analyze factors associated with urogenital sepsis post-PCNL.
- To develop and validate a nomogram prediction model for urogenital sepsis after PCNL.
Main Methods:
- Retrospective, multicenter study including 2066 PCNL patients.
- Logistic regression analysis identified risk factors in a training cohort (N.=1139).
- Nomogram model validated internally (N.=484) and externally (N.=443).
Main Results:
- Five independent risk factors identified: positive urine culture (OR=5.29), positive urine nitrite (OR=5.97), operation time ≥60 min (OR=4.4), residual stone (OR=5.18), and stone size ≥30 mm (OR=3.22).
- The nomogram demonstrated strong predictive accuracy with AUCs ranging from 0.804 to 0.948 across validation cohorts.
- Good calibration and clinical utility were confirmed by calibration curves and decision curve analysis.
Conclusions:
- A nomogram model effectively predicts urogenital sepsis risk after PCNL.
- The model incorporates urine culture/nitrite status, operation duration, and stone characteristics.
- This tool can assist urologists in preoperative risk assessment and treatment strategy development.
Related Concept Videos
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
15
Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
15
01:26Urine Studies II: Urine Culture and Sensitivity Test
36
A urine culture and sensitivity test is a diagnostic procedure used to identify urinary tract bacterial infections and determine the most effective antibiotics for treatment. This test is generally preferred when a patient shows manifestations of a urinary tract infection, such as frequent or painful urination, cloudy or foul-smelling urine, or lower abdominal pain.Purpose of the TestThe primary goals of a urine culture and sensitivity test are to:Determine the specific bacteria causing the...
36
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
19
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
19
01:25Urinary Tract Infection II: Pathophysiology
18
The pathophysiology of urinary tract infections (UTIs) encompasses several progressive stages, beginning with bacterial colonization and culminating in potential systemic complications if untreated. UTIs are primarily initiated by bacteria, such as Escherichia coli, which often originate from the gastrointestinal tract and migrate to the urinary system through the periurethral area. This migration can occur via several routes, including improper hygiene practices, sexual activity, or...
18
01:27Acute Pyelonephritis I: Introduction
20
Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such...
20
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
14
A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
14