Abstract:Objective To construct and validate a risk scoring tool for urinary tract infection (UTI) after ureteroscopic holmium laser lithotripsy(UHLL). Methods A total of 414 post-UHLL patients in the department of urology in a tertiary first-class hospital in Yichang City from January 2018 to December 2021 were selected as study objects through convenient sampling. According to a random number table, 288 patients were randomly assigned to the modeling group, and 126 patients to the validation group, in a 7 ∶3 ratio. Risk factors for UTI in patients after UHLL were identified via univariate and multivariate logistic regression analysis. Based on the data from the mode-ling group, a risk prediction model for post-UHLL UTI was constructed and a nomogram was depicted accordingly, the model was validated through data in validation group. The goodness of fit and predictive performance of the model were assesed using receiver operating characteristic (ROC) curve and Hosmer-Lemeshow test. A risk scoring tool based on the risk prediction model was constructed and applied in clinical practice. Results Among the 414 patients, 68 (16.43%) experienced postoperative UTI. Univariate analysis showed that age, history of smoking, diabetes, chronic diseases, hydronephrosis, and preoperative UTI, as well as preoperative serum protein level, history of azotemia, abnormal liver function, abnormal renal function, intraoperative perfusion time, stone size, urinary catheter retention days, duration of antimicrobial use, and combined use of antimicrobial were influencing factors for the occurrence of UTI in patients after UHLL. Multivariate logistic regression analysis revealed that age, history of diabetes, abnormal renal function, intraoperative perfusion time and combined use of antimicrobial agents were independent influencing factors for post-UHLL UTI. The area under ROC curve of the prediction model was 0.735, the maximum Yoden index was 0.448, the corresponding sensitivity and specificity were 73.3% and 71.5%, respectively and the critical value was determined as 5.5 points. With a cut-off value of 6 points, patients were divided into a low-risk group (0-5 points) and a high-risk group (6-13 points). Applying the post-UHLL UTI risk scoring tool in clinical practice yielded an accuracy of 86.8%, demonstrating favorable clinical utility. Conclusion The risk scoring tool provides guidance for nursing staff by predicting personalized risk of post-UHLL UTI and assisting them in implementing early interventions.