Risk Factors and Prediction Model of Urosepsis in Patients with Diabetes After Percutaneous Nephrolithotomy

Overview

Journal BMC Urol

Publisher Biomed Central

Specialty Urology

Date 2021 Apr 29

PMID 33910537

Citations 12

Authors

Jun Liu

Qingya Yang

Jiayi Lan

Yang Hong

Xiaobo Huang

Bo Yang

Affiliations

Soon will be listed here.

Abstract

Objective: To analyze the risk factors of patients with diabetes mellitus (DM) and urosepsis after percutaneous nephrolithotomy (PCNL) for upper urinary tract stones and to develop a nomogram to predict postoperative urosepsis according to the risk factors.

Methods: The data of patients with type 2 diabetes who underwent one-stage PCNL due to upper urinary tract stones were retrospectively analyzed. The risk factors of patients with postoperative urosepsis were evaluated by univariate and multivariate logistic regression analysis, and the nomogram prediction model was developed according to the regression coefficient.

Results: One-stage PCNL was successfully completed in 241 patients with DM, and urosepsis occurred in 41 (17.0%) patients after PCNL. Based on multivariate logistic regression analysis, the independent risk factors associated with postoperative urosepsis included preoperative leukocyte elevation (OR = 3.973, P = 0.005), positive urine nitrite (OR = 3.697, P = 0.010), and positive urine culture (OR = 3.562, P = 0.002). According to the results of the logistic regression analysis model, staghorn stones (OR = 2.049, P < 0.1) and complete intraoperative stone clearance (OR = 0.431, P < 0.1), were used to develop the nomogram. Internal validation of the nomogram showed that the concordance index (C-index) was 0.725. Additionally, the Hosmer-Lemeshow test was performed, P = 0.938 > 0.05.

Conclusion: Preoperative leukocyte elevation, positive urine nitrite, and positive urine culture are independent risk factors for urosepsis after one-stage PCNL for patients with DM with upper urinary tract stones. The nomogram, which is based on independent risk factors that combine stone morphology and intraoperative stone clearance, can help predict the risk of postoperative urosepsis.

Citing Articles

Risk factors and an optimized prediction model for urosepsis in diabetic patients with upper urinary tract stones.

Gao C, Liu J, Wang D, Liu M, Qiu J Sci Rep. 2025; 15(1):8183.

PMID: 40065041 PMC: 11893776. DOI: 10.1038/s41598-025-91787-2.

The Development and Validation of a Nomogram for Predicting Sepsis Risk in Diabetic Patients with Urinary Tract Infection.

Tan H, Duan X, Qu W, Shu M, Zhong G, Liang L Medicina (Kaunas). 2025; 61(2).

PMID: 40005342 PMC: 11857402. DOI: 10.3390/medicina61020225.

Nomogram including renal pelvic pressure to predict the occurrence of urosepsis following percutaneous nephrolithotomy: a dual center retrospective study of 1,448 patients.

Xu H, Wang K, Cao Z, Wang W, Yang C, Yang Y Transl Androl Urol. 2024; 13(5):667-678.

PMID: 38855606 PMC: 11157403. DOI: 10.21037/tau-23-616.

Long non‑coding RNAs MALAT1, NEAT1 and DSCR4 can be serum biomarkers in predicting urosepsis occurrence and reflect disease severity.

Shen J, Pan L, Chen W, Wu Y Exp Ther Med. 2024; 28(1):289.

PMID: 38827469 PMC: 11140293. DOI: 10.3892/etm.2024.12578.

Lower Urinary Tract Inflammation and Infection: Key Microbiological and Immunological Aspects.

Dickson K, Zhou J, Lehmann C J Clin Med. 2024; 13(2).

PMID: 38256450 PMC: 10816374. DOI: 10.3390/jcm13020315.

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