Nomogram and scoring system for preoperative prediction of the risk of systemic inflammatory response syndrome in one-stage flexible ureteroscopy lithotripsy
BackgroundFlexible ureteroscopy lithotripsy (FURL) is a prevalent intervention for the management of upper urinary tract stones (UUTS). Assessing the onset of systemic inflammatory response syndrome (SIRS) in patients during and postoperatively is a critical determinant in the decision-making proces...
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Frontiers Media S.A.
2025-05-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2025.1592507/full |
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| author | Yuan Zhou Yuan Zhou Haiyan Zhang Haiyan Zhang Rentao Zhang Rentao Zhang Yinman Ding Yinman Ding Zhengquan Wang Zhengquan Wang Changming Lin |
| author_facet | Yuan Zhou Yuan Zhou Haiyan Zhang Haiyan Zhang Rentao Zhang Rentao Zhang Yinman Ding Yinman Ding Zhengquan Wang Zhengquan Wang Changming Lin |
| author_sort | Yuan Zhou |
| collection | DOAJ |
| description | BackgroundFlexible ureteroscopy lithotripsy (FURL) is a prevalent intervention for the management of upper urinary tract stones (UUTS). Assessing the onset of systemic inflammatory response syndrome (SIRS) in patients during and postoperatively is a critical determinant in the decision-making process regarding the necessity of preoperative ureteral stenting prior to FURL.Materials and methodsA total of 340 patients with UUTS who underwent one-stage FURL were analyzed retrospectively. Least absolute shrinkage and selection operator and multivariate logistic regression analysis were used to screen out independent risk factors, subsequently developing a nomogram. The predictive performance was internally assessed using the concordance index (C-index), receiver operating characteristic curve, and calibration curve. Additionally, we evaluated the risk of SIRS in the context of one-stage FURL, considering the impact of various available variables.ResultsAge, urinary white blood cells, urine bacterial culture, and systemic immune-inflammation index (SII) were integrated to establish a nomogram for prediction of the risk of SIRS in patients undergoing one-stage FURL. The SII exhibited the highest odds ratio (OR = 30.356) for SIRS. The nomogram demonstrated a favorable predictive performance with a C-index of 0.964 (95% CI = 0.932–0.996), an area under the curve of 0.935, and a calibration curve validating its accuracy. We further developed a scoring system and classified the risk of SIRS into four grades.ConclusionThe developed nomogram and risk scoring system demonstrate favorable predictive ability and clinical serviceability for the personalized estimation of SIRS risk in UUTS patients undergoing one-stage FURL. It is advisable to place a ureteral stent prior to FURL in individuals with an SII exceeding 1,300 and meeting one of the following criteria: age > 60 years, urinary white blood cell levels of 1+/2+/3+, or positive urine bacterial culture. The insights provided may assist clinicians in selecting safer therapeutic approaches for UUTS patients. |
| format | Article |
| id | doaj-art-89aa864fa57c4c1399a53e8233ea467b |
| institution | OA Journals |
| issn | 2296-875X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Surgery |
| spelling | doaj-art-89aa864fa57c4c1399a53e8233ea467b2025-08-20T02:16:10ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2025-05-011210.3389/fsurg.2025.15925071592507Nomogram and scoring system for preoperative prediction of the risk of systemic inflammatory response syndrome in one-stage flexible ureteroscopy lithotripsyYuan Zhou0Yuan Zhou1Haiyan Zhang2Haiyan Zhang3Rentao Zhang4Rentao Zhang5Yinman Ding6Yinman Ding7Zhengquan Wang8Zhengquan Wang9Changming Lin10Department of Urology Surgery, The People’s Hospital of Xuancheng City, Xuancheng, ChinaWannan Medical College, Wuhu, ChinaDepartment of Urology Surgery, The People’s Hospital of Xuancheng City, Xuancheng, ChinaWannan Medical College, Wuhu, ChinaDepartment of Urology Surgery, The People’s Hospital of Xuancheng City, Xuancheng, ChinaWannan Medical College, Wuhu, ChinaDepartment of Urology Surgery, The People’s Hospital of Xuancheng City, Xuancheng, ChinaWannan Medical College, Wuhu, ChinaDepartment of Urology Surgery, The People’s Hospital of Xuancheng City, Xuancheng, ChinaWannan Medical College, Wuhu, ChinaDepartment of Urology Surgery, Huaian 82 Hospital, Huaian, ChinaBackgroundFlexible ureteroscopy lithotripsy (FURL) is a prevalent intervention for the management of upper urinary tract stones (UUTS). Assessing the onset of systemic inflammatory response syndrome (SIRS) in patients during and postoperatively is a critical determinant in the decision-making process regarding the necessity of preoperative ureteral stenting prior to FURL.Materials and methodsA total of 340 patients with UUTS who underwent one-stage FURL were analyzed retrospectively. Least absolute shrinkage and selection operator and multivariate logistic regression analysis were used to screen out independent risk factors, subsequently developing a nomogram. The predictive performance was internally assessed using the concordance index (C-index), receiver operating characteristic curve, and calibration curve. Additionally, we evaluated the risk of SIRS in the context of one-stage FURL, considering the impact of various available variables.ResultsAge, urinary white blood cells, urine bacterial culture, and systemic immune-inflammation index (SII) were integrated to establish a nomogram for prediction of the risk of SIRS in patients undergoing one-stage FURL. The SII exhibited the highest odds ratio (OR = 30.356) for SIRS. The nomogram demonstrated a favorable predictive performance with a C-index of 0.964 (95% CI = 0.932–0.996), an area under the curve of 0.935, and a calibration curve validating its accuracy. We further developed a scoring system and classified the risk of SIRS into four grades.ConclusionThe developed nomogram and risk scoring system demonstrate favorable predictive ability and clinical serviceability for the personalized estimation of SIRS risk in UUTS patients undergoing one-stage FURL. It is advisable to place a ureteral stent prior to FURL in individuals with an SII exceeding 1,300 and meeting one of the following criteria: age > 60 years, urinary white blood cell levels of 1+/2+/3+, or positive urine bacterial culture. The insights provided may assist clinicians in selecting safer therapeutic approaches for UUTS patients.https://www.frontiersin.org/articles/10.3389/fsurg.2025.1592507/fullureteroscopy lithotripsyupper urinary tract stonesystemic inflammatory response syndromenomogramsystemic immune-inflammation indexinfection prevention |
| spellingShingle | Yuan Zhou Yuan Zhou Haiyan Zhang Haiyan Zhang Rentao Zhang Rentao Zhang Yinman Ding Yinman Ding Zhengquan Wang Zhengquan Wang Changming Lin Nomogram and scoring system for preoperative prediction of the risk of systemic inflammatory response syndrome in one-stage flexible ureteroscopy lithotripsy Frontiers in Surgery ureteroscopy lithotripsy upper urinary tract stone systemic inflammatory response syndrome nomogram systemic immune-inflammation index infection prevention |
| title | Nomogram and scoring system for preoperative prediction of the risk of systemic inflammatory response syndrome in one-stage flexible ureteroscopy lithotripsy |
| title_full | Nomogram and scoring system for preoperative prediction of the risk of systemic inflammatory response syndrome in one-stage flexible ureteroscopy lithotripsy |
| title_fullStr | Nomogram and scoring system for preoperative prediction of the risk of systemic inflammatory response syndrome in one-stage flexible ureteroscopy lithotripsy |
| title_full_unstemmed | Nomogram and scoring system for preoperative prediction of the risk of systemic inflammatory response syndrome in one-stage flexible ureteroscopy lithotripsy |
| title_short | Nomogram and scoring system for preoperative prediction of the risk of systemic inflammatory response syndrome in one-stage flexible ureteroscopy lithotripsy |
| title_sort | nomogram and scoring system for preoperative prediction of the risk of systemic inflammatory response syndrome in one stage flexible ureteroscopy lithotripsy |
| topic | ureteroscopy lithotripsy upper urinary tract stone systemic inflammatory response syndrome nomogram systemic immune-inflammation index infection prevention |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2025.1592507/full |
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