The study aims to identify whether gender differences exist in the sequential organ failure assessment (SOFA) score to the extent of affecting its predictive accuracy for septic shock after percutaneous nephrolithotomy (PCNL). A retrospective study of 612 patients undergoing PCNL was performed. The SOFA scores of male and female groups were compared to identify any gender differences. The ROC curve was used to find differences between the original and adjusted SOFA scores. Postoperative septic shock developed in 21 (3.43%) cases. A marginally significant discrepancy in median SOFA scores between genders was discovered in a subgroup of patients < 40 years old (p = 0.048). A gender difference existed in the SOFA score after PCNL, with greater proportion of high scores in female patients (p = 0.011). Male patients had a higher proportion of ≥ 2 sub-score in hepatic and renal systems than female patients, caused by their higher preoperative bilirubin and creatinine (p < 0.05). An adjusted SOFA score was created to replace the original postoperative SOFA score with the perioperative changed values of bilirubin and creatinine. Performance of the adjusted SOFA score for predicting septic shock was comparable with the original SOFA score (AUC 0.987 vs. 0.985, p = 0.932). Under the premise of ensuring 100% sensitivity, the adjusted SOFA score reduced the 43.7% (31/71) false-positive rate for predicting septic shock compared with the original SOFA score. In conclusion, the gender should not be neglected when applying SOFA score for patients after PCNL. The adjusted SOFA score eliminates negative effects caused by gender differences in predicting septic shock.

中文翻译：

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顺序器官衰竭评估（SOFA）在预测经皮肾镜取石术后感染性休克时的性别相关差异。

该研究旨在确定顺序器官衰竭评估（SOFA）评分中是否存在性别差异，以影响其经皮肾镜取石术（PCNL）后感染性休克的预测准确性。回顾性研究了612例接受PCNL的患者。比较男性和女性组的SOFA分数，以发现任何性别差异。ROC曲线用于查找原始SOFA分数和调整后SOFA分数之间的差异。术后发生败血性休克21例（3.43％）。在<40岁的患者亚组中，发现男女性别中位SOFA得分之间存在显着差异（p = 0.048）。PCNL后的SOFA评分存在性别差异，高分的女性患者比例更高（p = 0.011）。男性患者在肝和肾系统中≥2子评分的比例高于女性患者，这是由于其术前胆红素和肌酐较高（p <0.05）。创建了调整后的SOFA评分，以围手术期胆红素和肌酐的变化值代替原始的术后SOFA评分。调整后的SOFA评分用于预测败血性休克的表现与原始SOFA评分相当（AUC 0.987对0.985，p = 0.932）。在确保100％敏感性的前提下，与原始SOFA得分相比，调整后的SOFA得分将预测败血症性休克的假阳性率降低了43.7％（31/71）。总之，对PCNL后的患者应用SOFA评分时，不应忽略性别。