Analysis and application value of the nomogram for systemic inflammatory response syndrome after urinary calculi surgery

Objective: To investigate the influencing factors of systemic inflammatory response syndrome (SIRS) after urinary calculi surgery, and to construct a nomogram prediction model and analyze its predictive value.Methods: A total of 512 patients with urinary calculi admitted to our hospital from August 2019 to May 2022 were selected.According to whether SIRS occurred after surgery, they were divided into SIRS group (n=75) and non-SIRS group (n=437).The clinical data of the two groups were compared and a multivariate logistic regression model was used to analyze the influencing factors of SIRS after urinary calculi surgery.The R language was used to draw a nomogram model for predicting concurrent SIRS, and the receiver operating characteristic (ROC) curve was used to analyze the predictive performance of the nomogram prediction model.Results: The proportion of patients with diabetes mellitus, positive urinary leukocytes and staghorn calculi and the intraoperative perfusion pressure were higher in the SIRS group than in the non-SIRS group, and the operation time was longer in the SIRS group than in the non-SIRS group (all P< 0.05).Multivariate logistic regression analysis showed that co-existing diabetes mellitus (OR=8.268, 95% CI:1.058-64.613), positive urinary leukocytes (OR=10.631, 95%CI:2.641-42.796), high intraoperative perfusion pressure (OR=8.540, 95% CI:1.279-57.025), staghorn calculi (OR=14.569, 95% CI:3.112-68.209), and long operation time (OR=10.552, 95% CI:1.362-81.748) were risk factors for SIRS (all P< 0.05).The nomogrammodel for predicting SIRS after urinary calculi surgery showed that the C-index was 0.951.The area under the ROC curve (AUC) of the nomogram model for predicting SIRS after urinary calculi surgery was 0.951 (95% CI:0.226-0.984), the sensitivity was 82.67% and the specificity was 85.81%.Conclusion: Positive urinary leukocytes, staghorn calculi and intraoperative perfusion pressure are the influencing factors of SIRS after urinary calculi surgery and the nomogram prediction model has a certain predictive value for SIRS after urinary calculi surgery.