Analysis Of Risk Factors Of Urinary Tract Infection After Transurethral Plasma Resection Of Prostate And Construction Of Visual Early Warning Model

ObjectiveTo analyze the influencing factors of urinary tract infection in patients undergoing transurethral plasma prostatectomy,and establish a risk prediction nomogram model to provide basis for formulating targeted treatment and nursing plan.MethodsThe patients underwent transurethral plasmakinetic prostatectomy in the Department of Urology from December 2020 to September 2021 were selected as the research objects.The general clinical data(age,BMI,IPSS score,whether combined with other site infections,diabetes and hypertension)and intraoperative factors(preoperative catheterization,operation duration,urethral injury and intraoperative bleeding)and postoperative nursing factors(indwelling catheter material,model,replacement times,indwelling catheterization duration and bladder flushing duration)were collected.Univariate analysis and logistic regression analysis were used to identify the risk factors of PKRP complicated with urinary tract infection.The predictive nomogram model was constructed by rstudio software and verified internally and externally.Results1.In this study,414 patients with PKRP were selected as the research object,of which 312 cases were used as the modeling set,48 cases had urinary tract infection,and the incidence rate of urinary tract infection was 15.38%.The incidence of urinary tract infection was 15.68%.2.A total of 56 strains of pathogenic bacteria were cultured in urine culture,of which 35(62.50%)were Gram-negative bacteria,19(33.92%)were Gram-positive bacteria and 2(3.57%)were fungi.3.Univariate analysis showed that age≥65 years(P=0.048),complicated with other site infection(P=0.010),diabetes(P=0.032),preoperative catheterization(P=0.003),intraoperative urethral injury(P=0.000)),intraoperative blood loss≥100m L(P=0.046),indwelling catheter material(P=0.039),the replacement times of indwelling catheter(P=0.005),the duration of indwelling catheter(P=0.029)and the duration of bladder flushing(P=0.026)were associated with the occurrence of urinary tract infection after PKRP.Different BMI values(P=0.208),IPSS scores(P=0.651).Hypertension(P=0.134),operation time(P=0.181)and indwelling catheter type(P=0.298)did not affect the occurrence of urinary tract infection.4.Multivariate Logistic regression analysis showed that age≥65,other parts of infection,diabetes,preoperative catheterization,urethral injury,latex indwelling catheter,replacement of indwelling catheter,and days of indwelling catheterization≥6were independent risk factors for urinary tract infection(P<0.05).5.A nomogram model for predicting the risk of urinary tract infection after transurethral plasma prostatectomy was constructed and verified by bootstrap internal validation method.The prediction model showed that risk score increased gradually with age,other location infection,diabetes,preoperative catheterization,urethral injury,latex catheter retention,hair coloring catheter replacement times and number of indwelling catheterization days,and the risk of urinary tract infection increased.Bootstrap internal validation AUC=0.875(95%CI:0.706～0.892)and external validation AUC=0.869(95%CI:0.697～0.883),and the calibration prediction curve has a good fit with the standard curve,which indicates that the model has good discrimination and accuracy.ConclusionThe influencing factors of urinary tract infection after PKRP are complex.The risk prediction nomogram model has good prediction performance,which can provide basis for formulating targeted treatment and nursing plan of urinary tract infection after PKRP.