| 摘要 |
Objectives: The aims of the study are to analyze the potential risk factors associated with systemic inflammatory response syndrome
after percutaneous nephrolithotomy for renal stones and to establish a predictive model to prevent postoperative early urosepsis postoperative
with percutaneous nephrolithotomy and develop a novel nomogram.
Methods: Patients who had undergone percutaneous nephrolithotomy between June 2012 and December 2019 were enrolled and
classified into two groups according to their systemic inflammatory response status. Univariable and multivariable logistic regression analyses
were performed to identify the predictive factors associated with systemic inflammatory response syndrome after percutaneous
nephrolithotomy. The nomograms were developed by using the significant factors, and the discriminative ability was assessed using receiver
operating characteristic curve analyses.
Results: Two hundred sixty two patients with renal stones treated with percutaneous nephrolithotomy were enrolled, and systemic inflammatory
response syndrome occurred in 117 patients (44%) after percutaneous nephrolithotomy.Multivariable logistic regression analysis
revealed that the three factors independently related to systemic inflammatory response syndrome: renal stone size ≥3 cm, positive
preoperative urine white blood cells, and positive preoperative urine culture. According to the results, the logistic regression analyses of
significant factors were used to develop the nomogram. Developed nomogram prediction model displayed favorable fitting in the
Hosmer-Lemeshow test ( P = 0.938). Internal validation of the nomogramshowed that the area under the receiver operating characteristic
curve was 0.702.
Conclusions: Positive preoperative urine white blood cells, positive urine culture, and renal stone size ≥3 cm are the most significant
predictors. The novel nomogram helps identify high-risk individuals and facilitates the early detection of systemic inflammatory response
syndrome after percutaneous nephrolithotomy. |
