Predicting Urosepsis in Ureteral Calculi: External Validation of Hu’s Nomogram and Identification of Novel Risk Factors
<b>Background/Objectives</b>: Acute obstructive pyelonephritis caused by ureteral calculi is a severe urological emergency that can rapidly progress to life-threatening complications, including urosepsis. Early risk stratification is critical for timely intervention and improved patient...
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MDPI AG
2025-04-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/15/9/1104 |
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| author | Yuka Sugizaki Takanobu Utsumi Naoki Ishitsuka Takahide Noro Yuta Suzuki Shota Iijima Takatoshi Somoto Ryo Oka Takumi Endo Naoto Kamiya Hiroyoshi Suzuki |
| author_facet | Yuka Sugizaki Takanobu Utsumi Naoki Ishitsuka Takahide Noro Yuta Suzuki Shota Iijima Takatoshi Somoto Ryo Oka Takumi Endo Naoto Kamiya Hiroyoshi Suzuki |
| author_sort | Yuka Sugizaki |
| collection | DOAJ |
| description | <b>Background/Objectives</b>: Acute obstructive pyelonephritis caused by ureteral calculi is a severe urological emergency that can rapidly progress to life-threatening complications, including urosepsis. Early risk stratification is critical for timely intervention and improved patient outcomes. Although Hu’s nomogram has been proposed as a predictive tool for urosepsis, its external validation remains limited. This study aims to validate Hu’s nomogram in an independent cohort and identify novel clinical and imaging predictors of urosepsis. <b>Methods</b>: This retrospective cohort study included 341 patients diagnosed with ureteral calculi who underwent surgical intervention at a single institution between January 2019 and October 2023. Clinical, laboratory, and imaging data were collected. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of urosepsis. The predictive accuracy of Hu’s nomogram was evaluated using receiver operating characteristic curve analysis. <b>Results</b>: Among 341 patients, 66 (19.4%) developed urosepsis. Multivariate analysis identified female gender, corticosteroid use, lower platelet count, elevated C-reactive protein levels, positive urine white blood cell count, lower computed tomography attenuation values of calculi, and higher computed tomography attenuation values of hydronephrosis as independent predictors of urosepsis. Hu’s nomogram demonstrated a strong predictive performance (area under the curve: 0.761; 95% CI: 0.701–0.821), reaffirming its clinical utility for risk stratification. <b>Conclusions</b>: This study provides an external validation of Hu’s nomogram and identifies novel risk factors for urosepsis prediction, including corticosteroid use and imaging-based parameters. Incorporating these findings into clinical practice may enhance early risk stratification, facilitate timely interventions, and ultimately improve patient outcomes. |
| format | Article |
| id | doaj-art-3aef8b1f960a4afa86c4950b1dcf937d |
| institution | OA Journals |
| issn | 2075-4418 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj-art-3aef8b1f960a4afa86c4950b1dcf937d2025-08-20T02:24:45ZengMDPI AGDiagnostics2075-44182025-04-01159110410.3390/diagnostics15091104Predicting Urosepsis in Ureteral Calculi: External Validation of Hu’s Nomogram and Identification of Novel Risk FactorsYuka Sugizaki0Takanobu Utsumi1Naoki Ishitsuka2Takahide Noro3Yuta Suzuki4Shota Iijima5Takatoshi Somoto6Ryo Oka7Takumi Endo8Naoto Kamiya9Hiroyoshi Suzuki10Department of Urology, Toho University Sakura Medical Center, Sakura 285-8741, JapanDepartment of Urology, Toho University Sakura Medical Center, Sakura 285-8741, JapanDepartment of Urology, Toho University Sakura Medical Center, Sakura 285-8741, JapanDepartment of Urology, Toho University Sakura Medical Center, Sakura 285-8741, JapanDepartment of Urology, Toho University Sakura Medical Center, Sakura 285-8741, JapanDepartment of Urology, Toho University Sakura Medical Center, Sakura 285-8741, JapanDepartment of Urology, Toho University Sakura Medical Center, Sakura 285-8741, JapanDepartment of Urology, Toho University Sakura Medical Center, Sakura 285-8741, JapanDepartment of Urology, Toho University Sakura Medical Center, Sakura 285-8741, JapanDepartment of Urology, Toho University Sakura Medical Center, Sakura 285-8741, JapanDepartment of Urology, Toho University Sakura Medical Center, Sakura 285-8741, Japan<b>Background/Objectives</b>: Acute obstructive pyelonephritis caused by ureteral calculi is a severe urological emergency that can rapidly progress to life-threatening complications, including urosepsis. Early risk stratification is critical for timely intervention and improved patient outcomes. Although Hu’s nomogram has been proposed as a predictive tool for urosepsis, its external validation remains limited. This study aims to validate Hu’s nomogram in an independent cohort and identify novel clinical and imaging predictors of urosepsis. <b>Methods</b>: This retrospective cohort study included 341 patients diagnosed with ureteral calculi who underwent surgical intervention at a single institution between January 2019 and October 2023. Clinical, laboratory, and imaging data were collected. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of urosepsis. The predictive accuracy of Hu’s nomogram was evaluated using receiver operating characteristic curve analysis. <b>Results</b>: Among 341 patients, 66 (19.4%) developed urosepsis. Multivariate analysis identified female gender, corticosteroid use, lower platelet count, elevated C-reactive protein levels, positive urine white blood cell count, lower computed tomography attenuation values of calculi, and higher computed tomography attenuation values of hydronephrosis as independent predictors of urosepsis. Hu’s nomogram demonstrated a strong predictive performance (area under the curve: 0.761; 95% CI: 0.701–0.821), reaffirming its clinical utility for risk stratification. <b>Conclusions</b>: This study provides an external validation of Hu’s nomogram and identifies novel risk factors for urosepsis prediction, including corticosteroid use and imaging-based parameters. Incorporating these findings into clinical practice may enhance early risk stratification, facilitate timely interventions, and ultimately improve patient outcomes.https://www.mdpi.com/2075-4418/15/9/1104external validationnomogramureteral calculiurosepsisrisk prediction |
| spellingShingle | Yuka Sugizaki Takanobu Utsumi Naoki Ishitsuka Takahide Noro Yuta Suzuki Shota Iijima Takatoshi Somoto Ryo Oka Takumi Endo Naoto Kamiya Hiroyoshi Suzuki Predicting Urosepsis in Ureteral Calculi: External Validation of Hu’s Nomogram and Identification of Novel Risk Factors Diagnostics external validation nomogram ureteral calculi urosepsis risk prediction |
| title | Predicting Urosepsis in Ureteral Calculi: External Validation of Hu’s Nomogram and Identification of Novel Risk Factors |
| title_full | Predicting Urosepsis in Ureteral Calculi: External Validation of Hu’s Nomogram and Identification of Novel Risk Factors |
| title_fullStr | Predicting Urosepsis in Ureteral Calculi: External Validation of Hu’s Nomogram and Identification of Novel Risk Factors |
| title_full_unstemmed | Predicting Urosepsis in Ureteral Calculi: External Validation of Hu’s Nomogram and Identification of Novel Risk Factors |
| title_short | Predicting Urosepsis in Ureteral Calculi: External Validation of Hu’s Nomogram and Identification of Novel Risk Factors |
| title_sort | predicting urosepsis in ureteral calculi external validation of hu s nomogram and identification of novel risk factors |
| topic | external validation nomogram ureteral calculi urosepsis risk prediction |
| url | https://www.mdpi.com/2075-4418/15/9/1104 |
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