Objective: To access the risk factors of systemic inflammatory response syndrome (SIRS) after transrectal ultrasound-guided biopsy of the prostate (TRUS-Bp) and establish a model and a nomogram for the prediction of SIRS after TRUS-Bp.
Methods: We retrospectively analyzed the clinical data on 752 cases of TRUS-Bp in our hospital from January 2010 to January 2017 and included 570 of the cases in this study. We investigated the independent risk factors for SIRS after TRUS-Bp by univariate and logistic regression analyses, constructed a prediction model and nomogram with the R-Statistics software, evaluated the discrimination of the model with the ROC curve, and measured the conformity by SPSS25.0 Bootstrap sampling.
Results: At 1－2 postoperative days, 58 (10.2%) of the 570 patients were diagnosed with SIRS, 22 (3.9%) with bacteremia, and 6 (1.1%) with septic shock, but none died. Logistic regression analysis showed that the independent risk factors for SIRS after TRUS-Bp included old age (>70 yr; OR = 1.1, P = 0.01), high number of biopsy needles (>10; OR = 2.3, P < 0.01), diabetes mellitus (OR = 3.4, P < 0.01), and hypoproteinemia (OR = 2.5, P < 0.01). The area under the ROC curve was 0.947 and internal validation showed a conformity of 92%.
Conclusions: Old age (>70 yr), high number of biopsy needles (>10), diabetes mellitus and hypoproteinemia may increase the risk of SIRS after TRUS-Bp. Evaluation with a model nomogram may help predict the probability of SIRS after TRUS-Bp.
Keywords: nomogram; risk factors; systemic inflammatory response syndrome; transrectal ultrasound-guided prostate biopsy.