Predictive Accuracy Of The Modified SOFA Score For Septic Shock After Percutaneous Nephrolithotomy

Purpose: Prior studies suggested that the accuracy of the SOFA score in predicting the hospital mortality of septic patients is more noteworthy than SIRS and q SOFA,which supports its application as a clinical diagnostic standard for sepsis.However,there are few research reports on its application in the field of urology.The purpose of this study was to determine the plausibility and utility of utilizing a modified SOFA(m SOFA)score for predicting uroseptic shock after mini-percutaneous nephrolithotomy.Methods: A cohort of 707 patients who received mini-PCNL from August 2019 to December 2020 was retrospectively evaluated.The area under receiver operating characteristic curve(AUROC)was used to compare the predictive value of septic shock between m SOFA,systemic inflammatory response syndrome(SIRS)and q SOFA.Results: Among 707 patients,24 patients experienced uroseptic shock after mini-PCNL.Compared with the no uroseptic shock group,the proportion of females and rates of preoperative urine culture,renal pelvis urine culture and stone culture positivity were higher in the uroseptic shock group,with high levels of preoperative C reactive protein(CRP)and postoperative procalcitonin(PCT).In the uroseptic shock group,the m SOFA score increased by two or more points in 83.3%;79.2% had at least two SIRS criteria,and 100% had a q SOFA score of at least one point.m SOFA score(AUROC = 0.866,95% CI: 0.779-0.954)exhibited greater discrimination for uroseptic shock after PCNL than SIRS(AUROC =0.838,95% CI: 0.742-0.943)and q SOFA(AUROC = 0.851,95% CI:0.811-0.892).Conclusion: The predictive value of the modified SOFA score for uroseptic shock after mini-PCNL was greater than that of the q SOFA score or SIRS.