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Nomogram for predicting risk factors of fever in patients with negative preoperative urine culture after retrograde intrarenal surgery

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Abstract

Purpose

To determine the risk factors for postoperative fever after retrograde intrarenal surgery (RIRS) in patients with negative preoperative urine culture (UC), and to establish a nomogram for predicting postoperative fever based on these risk factors.

Methods

This study collected 322 patients with negative UC who received RIRS at the First Affiliated Hospital of Anhui Medical University from March 2019 to May 2022. The study population was divided into a fever group and a non-fever group. The risk factors of postoperative fever were determined by univariate and multivariate logistic regression analyses, and a nomogram was established. The nomogram was evaluated in terms of differentiation, calibration, and clinical practicability.

Results

In this study, 47 (14.6%) patients developed a fever after surgery. Multivariate logistic regression analysis showed that for patients with negative preoperative urine culture, urinary leucocyte esterase (P = 0.005), operative time (P = 0.019), and intraoperative hypotension (P = 0.028) were independent risk factors of postoperative fever, and a nomogram was constructed according to the above variables. The area under the curve (AUC) calculated by receiver operating characteristic (ROC) analysis was 0.807 (95% CI 0.739–0.876), indicating good discrimination. The calibration curves showed good consistency, and the clinical decision curve analysis (DCA) showed the clinical applicability of the model.

Conclusions

For patients with negative preoperative urine culture, urine leukocyte esterase, operative time, and intraoperative hypotension are independent risk factors of postoperative fever. The new nomogram can better assess the risk of infection in patients with negative UC after RIRS.

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Funding

This work was supported by the National Natural Science Foundation of China (82070724) and Natural Science Foundation of Anhui Province (1908085MH246).

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Author notes

  1. Qiao Qi, Yongtao Hu, and Yang Chen contributed equally to this work.

Authors and Affiliations

  1. Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

    Qiao Qi, Yongtao Hu, Yang Chen, Qunsheng Yan, Yuexian Xu, Hu Liang, Chaozhao Liang & Zongyao Hao

  2. Institute of Urology and Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China

    Qiao Qi, Yongtao Hu, Yang Chen, Qunsheng Yan, Yuexian Xu, Hu Liang, Chaozhao Liang & Zongyao Hao

Authors
  1. Qiao Qi
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  2. Yongtao Hu
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  3. Yang Chen
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  4. Qunsheng Yan
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  5. Yuexian Xu
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  6. Hu Liang
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Contributions

QQ contributed to project development, data collection, data analysis, and manuscript writing; HYT contributed to data collection, data analysis, and manuscript writing; CY contributed to data collection and manuscript writing; YQS contributed to data collection and data analysis; XYX contributed to data collection; LH contributed to data collection; LCZ contributed to manuscript editing; HZY contributed to manuscript editing.

Corresponding authors

Correspondence to Chaozhao Liang or Zongyao Hao.

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Conflict of interest

The authors declare that there is no conflict of interest in this research.

Ethical approval

The study was approved by the Ethics Committee of The First Affiliated Hospital of Anhui Medical University (PJ-2022-12-23). Written informed consent for participation was not required for this study in accordance with the national legislation and the institutional requirements.

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Qi, Q., Hu, Y., Chen, Y. et al. Nomogram for predicting risk factors of fever in patients with negative preoperative urine culture after retrograde intrarenal surgery. World J Urol 41, 783–789 (2023). https://doi.org/10.1007/s00345-023-04302-5

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