A novel preoperative risk score for predicting Urosepsis after percutaneous nephrolithotomy: validation and clinical application.

Urinary tract infection (UTI) is a common and serious complication after percutaneous nephrolithotomy (PCNL).This study develops and validates the PuRass scoring system to predict the risk of UTI, including urinary sepsis, after PCNL and support personalized clinical Management. A retrospective analysis of 293 PCNL patients was conducted, incorporating multiple risk factors, including gender, age, diabetes, preoperative white blood cell count, urine analysis and culture results, stone size and type, and the degree of hydronephrosis. Significant risk factors were identified through meta-analysis and integrated into PuRass, with each factor weighted according to its odds ratio (OR) value to establish a quantitative risk assessment model. Results showed that gender, age, diabetes, elevated white blood cell count, and positive urine analysis and culture results significantly increased the risk of post-PCNL UTI. The PuRass model demonstrated excellent predictive performance in ROC curve analysis, achieving 90% sensitivity and 89.4% specificity, with an optimal threshold of 8.5 points. Early intervention strategies based on PuRass effectively reduced infection rates and hospital stays in high-risk patients. This study indicates that PuRass provides a reliable tool for predicting and managing post-PCNL UTI. Future multicenter studies will further validate its clinical applicability and explore its integration with emerging technologies to enhance postoperative management.