ASSESSMENT OF UROGENIC SEPSIS RISK FACTORS AND MODEL VALIDATION: IMPLICATIONS FOR ATHLETE HEALTH AND SAFETY IN SPORTS MEDICINE

Abstract

Objective: To identify and validate risk factors for urogenic sepsis in athletes undergoing procedures for urinary tract issues, using a Logistic regression model. This study also aims to establish an early warning model for urogenic sepsis applicable in sports medicine. Method: This retrospective study analyzed 145 athletes who underwent percutaneous nephrolithotomy (PCNL) for upper urinary tract calculi at a sports medicine clinic from April 2021 to April 2023. Patients were categorized into a urogenic sepsis group (n=35) and a non-urogenic sepsis group (n=110). Data on demographics and clinical indicators were collected. Univariate and multivariate Logistic regression analyses were conducted to pinpoint independent risk factors for urogenic sepsis. The diagnostic efficacy of the developed early warning model was assessed using the receiver operating curve (ROC). Results: Significant differences were found between the two groups in factors including BMI, stone characteristics, hydronephrosis, residual stones, inflammatory markers (WBC, FIB, D-D, CRP, TNF-α, IL-6), and procedural details (puncture channel, intraoperative irrigation volume, operation time). Independent risk factors identified included positive urine culture, use of microchannel for puncture, high intraoperative irrigation volume, and prolonged operation time, alongside elevated levels of PCT, TNF-α, and IL-6. The ROC curve analysis indicated high sensitivity (82.86%) and specificity (91.82%) for the early warning model, with external validation confirming its effectiveness. Conclusions: Athletes with urinary tract infections from upper urinary tract calculi are at risk of developing urogenic sepsis post-PCNL, particularly when specific risk factors are present. The early warning model developed in this study can effectively predict urogenic sepsis, offering a valuable tool for preemptive healthcare management in sports medicine. This model helps in mitigating risks and optimizing recovery strategies for athletes undergoing surgical interventions for urinary complications.