Xu Yanqiu, Xu Ping
Yanqiu Xu, Department of Urology, Suzhou Hospital of Integrated Traditional Chinese and Western Medicine, 39 Xiashatang, Suzhou, Jiangsu Province 215000, P.R. China.
Ping Xu, Department of Orthopedics, Suzhou Hospital of Integrated Traditional Chinese and Western Medicine, 39 Xiashatang, Suzhou, Jiangsu Province 215000, P.R. China.
Pak J Med Sci. 2024 Jan-Feb;40(3Part-II):394-398. doi: 10.12669/pjms.40.3.8855.
To construct a predictive model of nosocomial infection in patients with upper urinary tract (UUT) stones after flexible ureterorenoscopy with laser lithotripsy (FURSLL).
Medical records of 196 patients with UUT stones who underwent FURSLL in Suzhou Hospital of Integrated Traditional Chinese and Western Medicine from December 2019 to December 2022 were retrospectively analyzed. Patients were divided into infected group or uninfected group based on the presence of infection during postoperative hospitalization. Univariate and multivariate logistic regressions were used to identify risk factors of postoperative nosocomial infections. A nomogram prediction model was constructed using R software. The predictive ability of the model was assessed using the receiver operating characteristic (ROC) curve.
A total of 54 patients (27.6%) developed nosocomial infections after FURSLL. Logistic regression analysis showed that older age, diabetes, preoperative urinary system infection, ureteral stricture, hydronephrosis, double J-stent retention time, and stone diameter were risk factors of nosocomial infection. The nomogram model was constructed based on these risk factors. The ROC showed that the area under the curve (AUC) of the model was 0.930 (95% CI: 0.890-0.970), and the sensitivity and specificity were 92.6% and 81.7%, respectively, indicating that the prediction model was effective.
Risk of nosocomial infection in patients with UUT stones after FURSLL is affected by older age, diabetes, preoperative urinary system infection, ureteral stenosis, hydronephrosis, double J-stent retention time, and stone diameter. The nomogram prediction model, constructed based on the above factors, has good predictive value.
构建输尿管软镜联合激光碎石术（FURSLL）治疗上尿路（UUT）结石患者医院感染的预测模型。
回顾性分析2019年12月至2022年12月在苏州市中西医结合医院接受FURSLL治疗的196例UUT结石患者的病历资料。根据术后住院期间是否发生感染将患者分为感染组和未感染组。采用单因素和多因素logistic回归分析确定术后医院感染的危险因素。使用R软件构建列线图预测模型。采用受试者工作特征（ROC）曲线评估模型的预测能力。
FURSLL术后共有54例患者（27.6%）发生医院感染。logistic回归分析显示，年龄较大、糖尿病、术前泌尿系统感染、输尿管狭窄、肾积水、双J管留置时间和结石直径是医院感染的危险因素。基于这些危险因素构建了列线图模型。ROC曲线显示，模型的曲线下面积（AUC）为0.930（95%CI：0.890-0.970），灵敏度和特异度分别为92.6%和81.7%，表明该预测模型有效。
FURSLL术后UUT结石患者发生医院感染的风险受年龄较大、糖尿病、术前泌尿系统感染、输尿管狭窄、肾积水、双J管留置时间和结石直径的影响。基于上述因素构建的列线图预测模型具有良好的预测价值。
