Nomogram and scoring system for preoperative prediction the risk of systemic inflammatory response syndrome in patients undergoing one-stage flexible ureteroscopy lithotripsy

Objectives To develop an effective predictive tool for preoperative prediction the risk of systemic inflammatory response syndrome (SIRS) in one-stage flexible ureteroscopic lithotripsy (FURL). Materials and methods A total of 340 patients with upper urinary tract stone (UUTS) who underwent one-stage FURL from April 2021 to May 2024 were analyzed retrospectively. We used least absolute shrinkage and selection regression and multivariate logistic regression analysis to screen out independent risk factors and then developed a nomogram. Concordance index (C-index), receiver operating characteristic curve and calibration curve were used to internal evaluated the predictive ability. Decision curve analysis (DCA) was used to test the clinical serviceability of the nomogram. We further evaluated the risk of SIRS in one-stage FURL based on the influence of available variables. Results : Age, urinary white blood cells, urine bacterial culture and systemic immune-inflammation index (SII) were combined to establish nomogram for prediction the risk of SIRS in one-stage FURL. The SII had the highest odds ratio (OR = 30.356) to SIRS. The C-index (0.964, 95%CI = 0.932–0.996), area under curve (0.935), and calibration curve demonstrated the favourable predictive ability of nomogram prediction. DCA curve presented almost all patients in this study were suitable for this nomogram. We further developed a scoring system and classified the risk of SIRS into four grades. Conclusion The established nomogram and risk scoring system have favourable predictive ability and clinical serviceability to personalize predict the SIRS risk in UUTS patients undergoing one-stage FURL. The proposed tool may help clinicians select effective treatment for UUTS patients.