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Predictive markers for infections after extracorporeal shockwave lithotripsy in patients with kidney stone based on a large prospective cohort

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Abstract

Objective

Infections in patients with kidney stones after extracorporeal shockwave lithotripsy (SWL) is a common clinical issue. However, the associated factors are unclear. Therefore, we aim to develop and validate a predictive model for infections after SWL in patients with kidney stone.

Methods

Between June 2020 and May 2022, consecutive kidney stone patients were enrolled. Of them, 553 patients comprised the development cohort. One hundred sixty-five patients comprised the validation cohort. The data were prospectively collected. The stepwise selection was applied using the likelihood ratio test with Akaike’s information criterion as the stopping rule; A predictive model was constructed through multivariate logistic regression. The performance was evaluated regarding discrimination, calibration, and clinical usefulness.

Results

Predictors of infections after SWL in treating kidney stones included older age (OR = 1.026, p = 0.041), female (OR = 2.066, p = 0.039), higher BMI (OR = 1.072, p = 0.039), lower stone density (OR = 0.995, p < 0.001), and higher grade of hydronephrosis (OR = 5.148, p < 0.001). For the validation cohort, the model showed good discrimination with an area under the receiver operating characteristic curve of 0.839 (95% CI 0.736, 0.941) and good calibration. Decision curve analysis demonstrated that the model was also clinically useful.

Conclusion

This study indicated that age, gender, BMI, stone density, and hydronephrosis grade were significant predictors of infections after SWL in treating kidney stones. It provided evidence in optimizing prevention and perioperative treatment strategies to reduce the risk of infection after SWL.

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Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

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Acknowledgements

We give special thanks to all our colleagues at the Department of Urology of Shengjing Hospital for their help and support. The authors would like to thank all of the study participants.

Funding

This study was financially supported by The 345 Talent Project of Shengjing Hospital, the Natural Science Foundation of Liaoning Science and Technology Department (Grant No. 2020-BS-093), and the Natural Science Foundation of Liaoning Education Department (Grant No. QN2019013). These sponsors had no role in the study design; in the collection, analysis, or interpretation of data; in the report's writing; or in the decision to submit the article for publication.

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Author notes

  1. Bitian Liu, Shen Pan and Lu Wang have contribute equally to this work.

Authors and Affiliations

  1. Department of Urology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Shenyang, Liaoning, 110004, People’s Republic of China

    Bitian Liu, Lu Wang, Song Bai & Dongmei Liu

  2. Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, People’s Republic of China

    Shen Pan

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  1. Bitian Liu
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Contributions

Song Bai, and Dongmei Liu had full access to all the data in the study and took responsibility for the integrity of the data and the accuracy of the data analysis. Song Bai, and Dongmei Liu: Protocol/project development. Bitian Liu, Shen Pan, Lu Wang, Song Bai, and Dongmei Liu: Data collection or management. Bitian Liu, Shen Pan, Lu Wang, Song Bai, and Dongmei Liu: Data analysis. Bitian Liu, Shen Pan, Lu Wang, and Dongmei Liu: Manuscript writing/editing/revision.

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Correspondence to Song Bai or Dongmei Liu.

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Conflict of interest

All authors have no competing interests.

Consent for publication

Informed consent from all eligible patients was obtained.

Ethics approval and consent to participate

Ethical approval (2020PS520K) was provided by the Institutional Research and Ethics Committee of the Shengjing Hospital Affiliated China Medical University. Informed consent was obtained from all eligible subjects. The clinical research registry UIN is ChiCTR2000033789. The study protocol conformed to the ethical guidelines of the 1975 Declaration of Helsinki.

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Liu, B., Pan, S., Wang, L. et al. Predictive markers for infections after extracorporeal shockwave lithotripsy in patients with kidney stone based on a large prospective cohort. World J Urol 42, 63 (2024). https://doi.org/10.1007/s00345-024-04769-w

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