Scholarlink

Background <p>Percutaneous nephrolithotomy (PCNL) for renal stones is associated with infectious complications—fever (~ 20–30%), SIRS (~ 40%), and sepsis (&lt; 10%)—which can cause significant morbidity if not predicted early. Reliable risk-prediction tools may enable timely intervention.</p> Objective <p>To develop and internally validate logistic regression–based nomograms predicting postoperative fever, SIRS, and sepsis after PCNL.</p> Methods <p>We analyzed 800 adult patients undergoing PCNL (2020–2025). Comprehensive data was collected, including preoperative, intraoperative, and postoperative variables. Univariate analysis was done and predictors significant for each model were evaluated further. Separate multivariable logistic regression models were constructed, converted into nomograms, and assessed using AUCs with 95% CIs, bootstrap validation, and calibration plots.</p> Results <p>Postoperative Procalcitonin(PCT) was the strongest independent predictor across outcomes (for sepsis: OR 1.21 per 1 ng/mL; 95% CI 1.06–1.38; <i>p</i> = 0.005). Larger stone size, alkaline urine pH, and positive urine culture were also significant, while operative variables were not. Incidence rates were 44.5% (fever), 27.0% (SIRS), and 8.1% (sepsis). Model discrimination was good, with AUCs of 0.82 for fever, 0.79 for SIRS, and 0.85 for sepsis. Bootstrap validation showed minimal optimism.</p> Conclusion <p>These internally validated nomograms demonstrate acceptable predictive performance for post-PCNL infectious complications and may provide practical tools for bedside risk stratification, supporting early intervention in high-risk patients and optimized resource allocation.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Predictive nomograms for safer PCNL: enhancing early detection of postoperative infectious complications and sepsis

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年5月24日

查看全文
  • Alok Dutta,
  • Sanjoy Kumar Sureka,
  • Arpan Yadav,
  • Sanchit Rustagi,
  • Uday Pratap Singh

摘要

Background

Percutaneous nephrolithotomy (PCNL) for renal stones is associated with infectious complications—fever (~ 20–30%), SIRS (~ 40%), and sepsis (< 10%)—which can cause significant morbidity if not predicted early. Reliable risk-prediction tools may enable timely intervention.

Objective

To develop and internally validate logistic regression–based nomograms predicting postoperative fever, SIRS, and sepsis after PCNL.

Methods

We analyzed 800 adult patients undergoing PCNL (2020–2025). Comprehensive data was collected, including preoperative, intraoperative, and postoperative variables. Univariate analysis was done and predictors significant for each model were evaluated further. Separate multivariable logistic regression models were constructed, converted into nomograms, and assessed using AUCs with 95% CIs, bootstrap validation, and calibration plots.

Results

Postoperative Procalcitonin(PCT) was the strongest independent predictor across outcomes (for sepsis: OR 1.21 per 1 ng/mL; 95% CI 1.06–1.38; p = 0.005). Larger stone size, alkaline urine pH, and positive urine culture were also significant, while operative variables were not. Incidence rates were 44.5% (fever), 27.0% (SIRS), and 8.1% (sepsis). Model discrimination was good, with AUCs of 0.82 for fever, 0.79 for SIRS, and 0.85 for sepsis. Bootstrap validation showed minimal optimism.

Conclusion

These internally validated nomograms demonstrate acceptable predictive performance for post-PCNL infectious complications and may provide practical tools for bedside risk stratification, supporting early intervention in high-risk patients and optimized resource allocation.