Abstract
To investigate the efficacy of super-mini-PCNL (SMP) and ureteroscopy in kidney stone (KS) sufferers and learn the risk factors of postoperative infection. A retrospective analysis was performed on 180 KS sufferers who were diagnosed and treated in our hospital from May 2019 to May 2021. They were enrolled into an observation group (OG, n = 104) and a control group (CG, n = 76) based on different treatment methods. Therein, the former was treated with SMP, while the latter was treated with ureteroscopy. The operation time, blood loss, hospital stay, recent stone-free rate (one week after operation), changes of serum creatinine (SCr), blood urea nitrogen (BUN), and cystatin C (CysC) levels before and after operation and complications were compared. Those sufferers were assigned to infected and uninfected groups based on their postoperative infection. The risk factors were assessed through logistic regression, and the model formula was established. The predictive value of this model for infection was tested through RO. Compared with CG, the operation time of the OG was longer, the blood loss and hospital stay were lower (P < 0.05), and the stone-free rate was higher (P < 0.05). Renal function indexes before and after treatment (P > 0.05) and postoperative complications revealed no significant difference (P > 0.05). Logistic regression analysis manifested that preoperative urinary tract infection (OR: 4.690, 95% CI: 1.170–18.802), preoperative blood glucose level (OR: 11.188, 95% CI: 2.106–59.442), positive urine culture (OR: 10.931, 95% CI: 2.453–48.705), and infectious stones (OR: 3.951, 95% CI: 1.020–15.300) were independently related to infection. The risk prediction equation is logit(p)=−8.913+1.545 × X1+2.415 × X2+2.392 × X3+1.374 × X4, with a goodness-of-fit value of 0.545. The AUC is 0.930, so SMP is superior to ureteroscopy in KS sufferers. Preoperative urinary tract infection, preoperative blood glucose level, positive urine culture, and infectious stones are independently related to infection.
Highlights
IntroductionKidney stone (KS) is one of the familiar diseases of urinary system
Logistic regression analysis manifested that preoperative urinary tract infection (OR: 4.690, 95% CI: 1.170–18.802), preoperative blood glucose level (OR: 11.188, 95% CI: 2.106–59.442), positive urine culture (OR: 10.931, 95% CI: 2.453–48.705), and infectious stones (OR: 3.951, 95% CI: 1.020–15.300) were independently related to infection. e risk prediction equation is logit(p) −8.913 + 1.545 × X1 + 2.415 × X2+ 2.392 × X3 + 1.374 × X4, with a goodness-of-fit value of 0.545. e AUC is 0.930, so SMP is superior to ureteroscopy in kidney stone (KS) sufferers
Signal and multivariant logistic regression demonstrated that urinary tract infection (OR: 4.690, 95% CI: 1.170–18.802), preoperative blood glucose level (OR: 11.188, 95% CI: 2.106–59.442), positive urine culture (OR: 10.931, 95% CI: 2.453–48.705), and infectious stones (OR: 3.951, 95% CI: 1.020–15.300) were independent risk factors for infection (Tables 5 and 6; P < 0.05). e risk prediction equation was established based on multivariate logistic regression: logit(p) −8.913 + 1.545 × X1 + 2.415 × X2+ 2.392 × X3 + 1.374 × X4, and the regression equation goodness-of-fit was tested through the Hosmer–Lemeshow test (P 0.545). e established model was used to test the AUC of postoperative infection in KS sufferers with a value of 0.930 (Figure 3 and Table 7)
Summary
Kidney stone (KS) is one of the familiar diseases of urinary system. Statistics show that 5–15% of the global population is plagued by KS [1]. A survey found that the number of KS sufferers increased by 70% from 1994 to 2010 [2]. From 1992 to 2009, the rate of visits to emergency departments for stones increased by 91% [3]. Due to the mounting sufferers from population, obesity and metabolic syndrome (independent risk factors for KS), the annual cost of treatment in the US exceeds $10 billion in the medicare system [4]. Most stones will not have long-term consequences, it was once thought that KS is related to chronic kidney disease (CKD) [5]. The recurrence rate is very high: 50% within 5–10 years and 75% within 20 years [6]. The recurrence rate is very high: 50% within 5–10 years and 75% within 20 years [6]. us, choosing an effective treatment plan is the key to improve the current situation
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