Risk factors of systemic inflammatory response syndrome in elderly patients after percutaneous nephrolithotomy and establishment of nomogram prediction model
TANG Qingfeng1, LIU Chengwan1, HUANG Xiaoke1, FAN Dibing2
1 Department of Urology, Xindu District People's Hospital of Chengdu City, Chengdu 610500, China; 2 Department of Urology, the First people's Hospital of Guangyuan City
Abstract：Objective: To investigate the risk factors of systemic inflammatory response syndrome (SIRS) and the establishment of a risk prediction contingency model for elderly patients with renal calculi after percutaneous nephrolithotomy. Methods： A retrospective analysis was conducted on 164 elderly patients with renal calculi undergoing percutaneous nephrolithotomy and holmium laser lithotripsy. Univariate and logistic regression analyses was used to screen for elderly patients with kidney stones after percutaneous nephrolithotomy and laser lithotripsy. The independent risk factors of SIRS were based on the selected independent risk factors to establish a nomogram prediction model, and the consistency, differentiation and predictive efficacy of the model were verified. Results： The univariate analysis and logistic regression analysis revealed age (OR=3.040, 95%CI: 1.249-7.403), diabetes (OR=4.422, 95%CI: 1.445-13.530), hydronephrosis (OR=1.754, 95%CI: 1.010-3.046), renal function (OR=2.917, 95%CI: 1.222-6.962), preoperative urine culture (OR=6.985, 95%CI: 1.583-30.827) and operative time (OR=1.156, 95%CI: 1.100-1.215) were independent risk factors for SIRS in elderly patients with renal calculi after percutaneous nephrolithotomy and holmium laser lithotripsy (P < 0.05). A nomogram model was established to predict the risk of SIRS after percutaneous nephrolithotomy and holmium laser lithotripsy in elderly patients with renal calculi. The Bootstrap internal verification method verified that the predicted value was basically the same as the measured value, indicating that the prediction model was in good consistency. The C-index was 0.956 (95%CI: 0.919-0.993), indicating the good differentiation. The AUC of the prediction model was 0.956, indicating the efficacy of prediction model was high. Conclusion： The independent risk factors of SIRS after percutaneous nephrolithotomy and holmium laser lithotripsy in elderly patients with renal calculi were analyzed and a risk prediction model was successfully established. This model has guiding significance for the clinical prediction of SIRS after percutaneous holmium laser lithotripsy in elderly patients with renal calculi.
