Predictive risk factors for systemic inflammatory response syndrome following ureteroscopic laser lithotripsy
| Autor: | Toshihiko Tsujii, Sachi Kitayama, Yusuke Uchida, Ryoji Takazawa |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Nephrology medicine.medical_specialty Ureteral Calculi Adolescent Urology medicine.medical_treatment Urinary Bladder 030232 urology & nephrology Lithotripsy law.invention Young Adult 03 medical and health sciences Postoperative Complications 0302 clinical medicine Japan Risk Factors law Internal medicine Preoperative Care Ureteroscopy medicine Humans Risk factor Aged Retrospective Studies Aged 80 and over Univariate analysis Pyelonephritis business.industry Incidence Stent Middle Aged Lithotripsy Laser medicine.disease Laser lithotripsy Intensive care unit Systemic Inflammatory Response Syndrome Anti-Bacterial Agents Surgery Systemic inflammatory response syndrome Treatment Outcome 030220 oncology & carcinogenesis Female Stents business Ureteral Obstruction |
| Zdroj: | Urolithiasis. 46:375-381 |
| ISSN: | 2194-7236 2194-7228 |
| DOI: | 10.1007/s00240-017-1000-3 |
| Popis: | The objective of this study was to investigate risk factors for the development of systemic inflammatory response syndrome following ureteroscopic laser lithotripsy. We retrospectively collected data of 469 patients who underwent ureteroscopic laser lithotripsy at our single institution from February 2008 to June 2016. Details for the patient, the stone, and the surgical factors that potentially contributed to postoperative infection were extracted. Using a logistic regression model, we analyzed how the clinical factors affected the incidence of systemic inflammatory response syndrome. Twenty-seven patients (5.7%) were postoperatively diagnosed with systemic inflammatory response syndrome; of these, 25 patients were diagnosed within 24 h after ureteroscopy. One patient required intensive care unit admission, but no death was reported. A preoperative stent was significantly associated with postoperative systemic inflammatory response syndrome only on univariate analysis, and the reasons for stenting were varied. Multivariate analysis revealed that obstructive pyelonephritis, a positive preoperative bladder urine culture result, and female gender were significantly associated with postoperative systemic inflammatory response syndrome. Patients who experienced obstructive pyelonephritis preceding ureteroscopic laser lithotripsy or had a positive preoperative bladder urine culture result were at an increased risk of systemic inflammatory response syndrome despite receiving appropriate preoperative antibiotic therapy. Regarding the impact of a preoperative stent on postoperative infection, further investigation focusing on reasons for stenting is needed. |
| Databáze: | OpenAIRE |
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