Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Sep 15, 2023; 14(9): 1403-1411
Published online Sep 15, 2023. doi: 10.4239/wjd.v14.i9.1403
Risk factors of concurrent urinary sepsis in patients with diabetes mellitus comorbid with upper urinary tract calculi
Jian-Jie Gou, Chao Zhang, Hai-Song Han, Hong-Wei Wu
Jian-Jie Gou, Chao Zhang, Hai-Song Han, Department of Urology Surgery, People’s Hospital of Jincheng, Jincheng 048000, Shanxi Province, China
Hong-Wei Wu, Emergency Department, People’s Hospital of Jincheng, Jincheng 048000, Shanxi Province, China
Author contributions: Gou JJ designed and performed the research and wrote the paper; Zhang C designed the research and supervised the report; Han HS designed the research and contributed to the analysis; Wu HW provided clinical advice; Zhang C, Han HS, and Wu HW supervised the report.
Institutional review board statement: The study was reviewed and approved by the Institutional review board of People’s Hospital of Jincheng (Approval No. JCPH.No20230401001).
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
Data sharing statement: Dataset available from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hong-Wei Wu, MM, Associate Chief Physician, Emergency Dep-artment, People’s Hospital of Jincheng, No. 456 Wenchang East Street, Zhongjiazhuang, Jincheng 048000, Shanxi Province, China. 13935660657@163.com
Received: June 6, 2023
Peer-review started: June 6, 2023
First decision: June 21, 2023
Revised: June 30, 2023
Accepted: July 18, 2023
Article in press: July 18, 2023
Published online: September 15, 2023
Abstract
BACKGROUND

Urinary sepsis is frequently seen in patients with diabetes mellitus (DM) complicated with upper urinary tract calculi (UUTCs). Currently, the known risk factors of urinary sepsis are not uniform.

AIM

To analyze the risk factors of concurrent urinary sepsis in patients with DM complicated with UUTCs by logistic regression.

METHODS

We retrospectively analyzed 384 patients with DM complicated with UUTCs treated in People’s Hospital of Jincheng between February 2018 and May 2022. The patients were screened according to the inclusion and exclusion criteria, and 204 patients were enrolled. The patients were assigned to an occurrence group (n = 78) and a nonoccurrence group (n = 126). Logistic regression was adopted to analyze the risk factors for urinary sepsis, and a risk prediction model was established.

RESULTS

Gender, age, history of lumbago and abdominal pain, operation time, urine leukocytes (U-LEU) and urine glucose (U-GLU) were independent risk factors for patients with concurrent urinary sepsis (P < 0.05). Risk score = 0.794 × gender + 0.941 × age + 0.901 × history of lumbago and abdominal pain - 1.071 × operation time + 1.972 × U-LEU + 1.541 × U-GLU. The occurrence group had notably higher risk scores than the nonoccurrence group (P < 0.0001). The area under the curve of risk score for forecasting concurrent urinary sepsis in patients was 0.801, with specificity of 73.07%, sensitivity of 79.36% and Youden index of 52.44%.

CONCLUSION

Sex, age, history of lumbar and abdominal pain, operation time, ULEU and UGLU are independent risk factors for urogenic sepsis in diabetic patients with UUTC.

Keywords: Diabetes mellitus, Upper urinary tract calculi, Urinary sepsis, Risk factors, Risk prediction model, Logistic regression, Concurrent urinary sepsis

Core Tip: This study was to determine risk factors of concurrent urinary sepsis in patients with diabetes mellitus comorbid with upper urinary tract calculi and construct a risk prediction model. Gender, age, history of lumbago and abdominal pain, operation time, urinary leukocytes and urinary glucose were independent risk factors for concurrent urinary sepsis. It is helpful to identify high-risk patients at an early stage and implement active and effective intervention measures to reduce complications and improve the prognosis of patients.