Mp40-01 External Validation of a Novel Nomogram to Stratify Risk of Sepsis in Patients Undergoing Ureteral Stent Placement for Obstructing Stones and Presumed Urinary Tract Infection

You have accessJournal of UrologyStone Disease: Epidemiology & Evaluation I (MP40)1 May 2024MP40-01 EXTERNAL VALIDATION OF A NOVEL NOMOGRAM TO STRATIFY RISK OF SEPSIS IN PATIENTS UNDERGOING URETERAL STENT PLACEMENT FOR OBSTRUCTING STONES AND PRESUMED URINARY TRACT INFECTION Michal Segall, Noah Hawks-Ladds, Jay Rollins, David E. Hinojosa-Gonzalez, Brian H. Eisner, Dima Raskolnikov, and Alexander Small Michal SegallMichal Segall , Noah Hawks-LaddsNoah Hawks-Ladds , Jay RollinsJay Rollins , David E. Hinojosa-GonzalezDavid E. Hinojosa-Gonzalez , Brian H. EisnerBrian H. Eisner , Dima RaskolnikovDima Raskolnikov , and Alexander SmallAlexander Small View All Author Informationhttps://doi.org/10.1097/01.JU.0001008788.18007.3f.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Urosepsis is a serious complication of obstructing stones and urinary tract infections (UTI), even after decompression with a ureteral stent or nephrostomy. Effective risk stratification is vital for clinical decision-making and hospital resource allocation. Recently, a novel nomogram was developed to evaluate risk of septic shock in this population (Figure 1). The present study aims to externally validate this nomogram with data from an external site with a large, diverse patient cohort. METHODS: A retrospective chart review was conducted on 226 patients with obstructing stones and infection who underwent stent placement at an academic medical center between January 2018 and August 2023. The nomogram was applied utilizing the previously identified risk factors: age, purulent urine, UTI history, WBC, lactate, and Quick Sequential Organ Failure Assessment (qSOFA) score. Patients were considered to be in septic shock in the postoperative period if they required vasopressor support within 1 hour after stent placement and had a positive qSOFA score. RESULTS: Patients' mean age was 53 +/- 17.5. Patients were 66% Hispanic, 16% Black, 12% Non-Hispanic White, and 4% Asian. 22 (9.7%) developed septic shock, compared to the original training model sepsis rate of 13.3%. Receiver operating characteristic (ROC) analysis revealed an Area Under the Curve (AUC) of 90.5% (p=.001), considered "excellent" for this prediction model (Figure 2). The AUC of the original nomogram was 81.1%. CONCLUSIONS: The validation model confirms the nomogram's high predictive performance, suggesting excellent generalizability to different patient populations. A prospective study is needed to determine whether nomogram utilization may help to identify those patients most likely to benefit from ICU admission. Download PPTDownload PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e662 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Michal Segall More articles by this author Noah Hawks-Ladds More articles by this author Jay Rollins More articles by this author David E. Hinojosa-Gonzalez More articles by this author Brian H. Eisner More articles by this author Dima Raskolnikov More articles by this author Alexander Small More articles by this author Expand All Advertisement PDF downloadLoading ...