Cai Li, Wu Xiaofen, Lian Xin, Zhou Qing
Department of Urology Department Zone 2, Lishui Municipal Central Hospital, Lishui City, China.
Department of Urology Surgery, Lishui Municipal Central Hospital, Lishui City, China.
Surg Infect (Larchmt). 2025 May;26(4):209-216. doi: 10.1089/sur.2024.212. Epub 2024 Nov 26.
To analyze the influencing factors of urinary tract stones complicated by urinary tract infections and construct a column chart prediction model. From July 2020 to October 2023, 345 patients with urinary tract stones admitted to our hospital were collected as the training set, they were separated into an infection group of 51 cases and a non-infection group of 294 cases on the basis of the presence or absence of concurrent urinary tract infections; 192 patients with urinary tract stones were used as the testing set and were divided into an infection group of 26 cases and a non-infection group of 166 cases on the basis of the presence or absence of concurrent urinary tract infections. Data such as gender, age, and procalcitonin (PCT) were recorded. Multi-variable logistic regression analysis was applied to screen predictive factors, R4.0.2 software was applied to construct a column chart model, the calibration curve and Receiver Operating Characteristic (ROC) curve were applied to evaluate the discrimination and calibration of the column chart model; decision curve analysis curve was applied to evaluate the predictive performance of column chart models. The proportions of female, diabetes mellitus, indwelling time of urinary catheter ≥7 days, the PCT, and urine pH in the infected group were greater than those in the non-infected group (p < 0.05). Female, diabetes mellitus, catheter retention time ≥7 days, high PCT, and high urine pH were independent risk factors for urinary calculi complicated with urinary tract infection (p < 0.05). Training set: C-index was 0.913, Area Under Curve (AUC) was 0.943 [95% Confidence Interval (CI) = 0.912-0.973], sensitivity was 86.36%, and specificity was 89.81%, testing set: C-index was 0.905, AUC was 0.959 (95% CI = 0.928-0.989), sensitivity was 84.65%, and specificity was 95.84%, indicating good discriminability of the line graph model; Hosmer-Lemeshow test showed = 2.843, 2.894, p = 0.944, 0.941, the calibration curve approached the ideal curve, and the line graph model had good calibration. When the risk threshold for urinary tract stones complicated by urinary tract infections was between 0.08 and 0.86, this column chart model provided clinical net benefits. The column chart prediction model for urinary tract stones complicated by urinary tract infections constructed in this study has high predictive efficiency and clinical practical value, and can provide reference for medical staff.
分析尿路结石合并尿路感染的影响因素并构建柱状图预测模型。收集2020年7月至2023年10月我院收治的345例尿路结石患者作为训练集,根据是否合并尿路感染分为感染组51例和非感染组294例;选取192例尿路结石患者作为测试集,根据是否合并尿路感染分为感染组26例和非感染组166例。记录性别、年龄、降钙素原(PCT)等数据。采用多变量逻辑回归分析筛选预测因素,应用R4.0.2软件构建柱状图模型,应用校准曲线和受试者工作特征(ROC)曲线评估柱状图模型的区分度和校准度;应用决策曲线分析曲线评估柱状图模型的预测性能。感染组女性、糖尿病、导尿管留置时间≥7天、PCT、尿pH值的比例高于非感染组(p<0.05)。女性、糖尿病、导尿管留置时间≥7天、高PCT、高尿pH值是尿路结石合并尿路感染的独立危险因素(p<0.05)。训练集:C指数为0.913,曲线下面积(AUC)为0.943[95%置信区间(CI)=0.912 - 0.973],灵敏度为86.36%,特异度为89.81%;测试集:C指数为0.905,AUC为0.959(95%CI = 0.928 - 0.989),灵敏度为84.65%,特异度为95.84%,表明折线图模型具有良好的区分度;Hosmer-Lemeshow检验显示χ² = 2.843、2.894,p = 0.944、0.941,校准曲线接近理想曲线,折线图模型具有良好的校准度。当尿路结石合并尿路感染的风险阈值在0.08至0.86之间时,该柱状图模型具有临床净效益。本研究构建的尿路结石合并尿路感染柱状图预测模型具有较高的预测效率和临床实用价值,可为医护人员提供参考。