评估输尿管镜碎石术患者术后尿毒症的发生率和风险因素。

IF 1.4 Q3 UROLOGY & NEPHROLOGY Central European Journal of Urology Pub Date : 2024-01-01 Epub Date: 2024-01-08 DOI:10.5173/ceju.2023.167
Krystian Kaczmarek, Marta Jankowska, Jakub Kalembkiewicz, Jakub Kienitz, Ositadima Chukwu, Artur Lemiński, Marcin Słojewski
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引用次数: 0

摘要

导言:输尿管镜碎石术(URSL)是一种已获批准的治疗尿路结石的微创、低风险手术。然而,一些患者可能会在手术后出现尿路感染(UTI),最终导致尿毒症。确定尿路结石手术后感染的预测因素将有助于识别尿毒症高风险患者,从而及早实施有效治疗。因此,我们旨在确定尿道上皮内切开术后尿道炎的发生率和预测因素:我们评估了 231 名使用钬激光进行尿路结石手术的患者。分析了治疗后 30 天内尿道炎的发生率,并研究了尿道炎的潜在预测因素,包括患者特征和个体临床因素:统计分析显示,16.88%的患者在手术前尿培养呈阳性。4.76%的患者在手术后出现尿毒症。单变量分析显示,有三个因素与术后尿毒症的风险显著相关:尿道支架植入术前插入双 J 支架、术前尿培养阳性、术前发现 MDR 病原。在多变量分析中,只有尿培养阳性仍与尿道上皮内切开术后尿路败血症的风险显著相关:结论:尿道上裂前尿培养阳性的患者术后发生尿毒症的风险明显更高。因此,在计划进行内镜下尿路结石治疗前,应常规进行尿培养。
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Assessment of the incidence and risk factors of postoperative urosepsis in patients undergoing ureteroscopic lithotripsy.

Introduction: Ureteroscopic lithotripsy (URSL) is an approved, minimally invasive, low-risk procedure for urolithiasis treatment. However, some patients may develop urinary tract infection (UTI) post-procedure, eventually leading to urosepsis. Determining the predictors of infection after URSL would help identify patients at a high risk of urosepsis, thereby enabling the early implementation of effective treatment. Therefore, we aimed to establish the incidence and predictors of urosepsis after URSL.

Material and methods: We assessed 231 patients who underwent URSL using a holmium laser. The incidence of urosepsis during the 30-day post-treatment period was analysed, and potential predictors of urosepsis, including patient characteristics and individual clinical factors, were examined.

Results: Statistical analysis revealed that 16.88% of patients had a confirmed positive urine culture before the procedure. Post-procedure urosepsis occurred in 4.76% of patients. Univariable analysis revealed that 3 factors were significantly associated with the risk of postoperative urosepsis: double-J stent insertion before URSL, pre-operative positive urine culture, and MDR pathogen found preoperatively. In multivariable analysis, only positive urine culture remained significantly associated with the risk of urosepsis after URSL.

Conclusions: Patients with positive urine culture before URSL are at significantly higher risk of urosepsis in the postoperative period. Hence, urine culture should be routinely performed before planned endoscopic urolithiasis treatment.

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来源期刊
Central European Journal of Urology
Central European Journal of Urology UROLOGY & NEPHROLOGY-
CiteScore
2.30
自引率
8.30%
发文量
48
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