Risk factors and prediction model for post-endoscopic lithotripsy infections.

OBJECTIVE

To identify independent risk factors for infectious complications (fever, SIRS, sepsis) after endoscopic lithotripsy and construct a multi-outcome hierarchical prediction model.

METHODS

Retrospective study of 914 patients (n = 914). Primary analysis used multinomial logistic regression for sepsis; sensitivity analysis used binary logistic regression for fever and SIRS with backward elimination. Bootstrap validation, AUC, calibration (MAE), and DCA were performed.

RESULTS

Primary analysis: positive urine culture (OR = 3.36), previous surgery (OR = 3.62), radiological signs of infection (OR = 4.02), and combined surgery (OR = 4.95) were independent risk factors for sepsis (AUC=0.794, MAE=0.008). Fever model: radiological signs and surgical modality (AUC=0.715). SIRS model: radiological signs and ULE+++ (OR = 5.1, AUC=0.73). DCA showed net clinical benefit for all three models.

CONCLUSION

The multi-outcome hierarchical model effectively predicts postoperative infection risk. Nomograms guide individualized perioperative interventions.