Development and validation of a novel nomogram for predicting systemic inflammatory response syndrome’s occurrence in patients undertaking flexible ureteroscopy

作者：Zijun Xuan, Zhikang Yu, Guobin Tan, Ning Ding, Huibin He, Shichao Yu, Guoqing Liu, Xiping Zhu, Bo Zhu, Zhe Liu · 发表于：Translational Andrology and Urology · 年份：2022 · DOI：10.21037/tau-22-34 · 被引用次数：12 · 研究领域：Kidney Stones and Urolithiasis Treatments、Urinary Tract Infections Management、Acute Kidney Injury Research

Background: The occurrence of systemic inflammatory response syndrome (SIRS) is an early alert for sepsis after flexible ureteroscopy (fURS). Once sepsis occurs, it often leads to severe or fatal consequences. We aimed to identify SIRS patients preoperatively by developing and validating a feasible prognostic nomogram model based on retrospective cohort analysis. Methods: A total of 311 patients who underwent fURS in Dongguan Kanghua Hospital (Dongguan, China) between 2016 and 2020 were included and randomly divided into a primary cohort (n=219) and validation cohort (n=92). Single factor regression analysis was used to identify the primary cohort's meaningful characters between SIRS and non-SIRS groups. Factors of the primary cohort were then identified by least absolute shrinkage and selection operator (LASSO) regression analysis, and a nomogram was built to execute the subsequent analysis using these factors. Finally, we analyzed and drew the calibration curve, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA) curve to validate the prognostic value of the nomogram in calibration and discrimination. Results: Review of the single regression analysis of characters in the primary cohort showed gender, stone burden, diabetes, neutrophil (N), lymphocyte (L), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocytes ratio (LMR), urine-WBC, nitrite (Nit), urine culture, and surgery time as significant factors b...