A quick stone component analysis matters in postoperative fever: a propensity score matching study of 1493 retrograde intrarenal surgery
| Autor: | Linjie Peng, Zihao Xu, Junjun Wen, Wen Zhong, Guohua Zeng |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Nephrology medicine.medical_specialty Time Factors Fever Urology 030232 urology & nephrology Urine Kidney Sepsis Kidney Calculi 03 medical and health sciences Postoperative fever Postoperative Complications 0302 clinical medicine Risk Factors Internal medicine Humans Medicine Propensity Score Retrospective Studies business.industry Septic shock Incidence (epidemiology) Middle Aged Nomogram medicine.disease Surgery 030220 oncology & carcinogenesis Urinary Tract Infections Propensity score matching Urologic Surgical Procedures Female business |
| Zdroj: | World Journal of Urology. 39:1277-1285 |
| ISSN: | 1433-8726 0724-4983 |
| Popis: | To evaluate the role of stone components in postoperative fever following RIRS, and to investigate the role of quick stone component analysis during RIRS procedure.1493 patients with RIRS were retrospectively reviewed. Propensity score matching (PSM) analysis was performed as infection stones (IS) vs. calcium-containing stones (CS) and IS vs. other compositions (OS). Independent risk factors of postoperative fever were identified by logistic analysis and nomogram was constructed.A total of 73 patients suffered postoperative fever (4.9%), 8 patients with sepsis (0.5%), 4 patients with septic shock (0.3%). In IS vs. CS, the incidence of positive urine test (28.4% vs. 14.7%, p = 0.001), residual stone (48.2% vs. 37.6%, p = 0.04), and postoperative fever (9.1% vs. 2.0%, p = 0.004) was significantly higher in IS. In IS vs. OS, IS had a higher incidence of positive urine test (30.9% vs. 9.3%, p 0.001) and residual stone (47.4% vs. 18.6%, p 0.001), while there was no significant difference in postoperative fever (10.3% vs. 4.1%, p = 0.17). Multivariate regression analysis revealed that gender (OR 1.82, CI 1.09-3.07, p 0.001), stone components (OR 0.6, CI 0.37-0.97, p = 0.038), urine test (OR 3.72, CI 2.23-6.20, p 0.001), and neutrophil ratio 75% (OR 5.17, CI 3.03-9.16, p 0.001) were independent risk factors for postoperative fever. A nomogram with moderate discriminative ability (c-index: 0.813) was constructed to predict postoperative fever.Infection stones were closely associated with postoperative fever following RIRS, as well as female gender, preoperative positive urine test, and postoperative neutrophil ratio 75%. A quick stone component analysis would help in prevention of infectious complications. Early and longer duration of antimicrobial therapy was recommended for patients with infection stones. |
| Databáze: | OpenAIRE |
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