Clinical characteristics of postoperative febrile urinary tract infections after ureteroscopic lithotripsy in diabetics: How to predict?

Kazan, Hüseyin Özgür; Çakıcı, Mehmet Çağlar; Efiloğlu, Özgür; Çiçek, Mustafa Cüneyt; Yildirim, A.; Atış, Gökhan

doi:10.1016/s1569-9056(19)33089-1

Cited by 8 publications

(11 citation statements)

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“…The European Research Journal 2023 ! that comorbidities such as preoperative pyuria, preoperative urine culture positivity, prolonged operation time, high Charlson Comorbidity index, and diabetes mellitus are associated with postoperative fever and SIRS [10][11][12]. In our study, a relationship was found between age, diabetes mellitus, cardiovascular disease, preoperative urine culture positivity and the development of SIRS.…”

Section: Discussionsupporting

confidence: 55%

The systemic immune-inflammation index (SII) in predicting postoperative systemic inflammatory response syndrome (SIRS) after ureteroscopy

Yahşi

Ceviz

2023

The European Research Journal

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Objectives: The predictive value of some preoperative inflammatory markers for postoperative infective complications in urinary system stone disease has been demonstrated. We investigated how valuable the systemic immune-inflammation index (SII) is as a marker for the development of postoperative systemic inflammatory response syndrome (SIRS) in patients undergoing ureteroscopy. Methods: The data of 495 patients who met the study criteria were evaluated retrospectively. The patients were divided into groups according to whether they developed SIRS postoperatively or not. The clinical and demographic data of the patient groups as well as blood parameters were evaluated. Results: Postoperative systemic inflammatory response syndrome was detected in 105 (21.2%) of the patients. Age, diabetes, cardiovascular disease, preoperative urinary culture positivity, SII, neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR) and platelet-lymphocyte ratio (PLR) were found to be significant for the development of SIRS. When the areas under the curve were measured in the ROC analysis, it was seen that the SII, NLR, LMR and PLR had high predictive values for the development of SIRS (area under the curve values of 0.73, 0.76, 0.72 and 0.67, respectively). In the multivariate logistic regression analysis, among the risk factors, age, cardiovascular disease, preoperative urinary culture positivity and NLR were determined as independent risk factors. Conclusions: Study revealed that only NLR among inflammatory markers is an independent risk factor for the development of SIRS. Although there is a relationship between the preoperative SII and the development of SIRS, it is not an independent risk factor. Along with many other variables, it may contribute to the development of SIRS.

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Section: Discussionsupporting

confidence: 55%

The systemic immune-inflammation index (SII) in predicting postoperative systemic inflammatory response syndrome (SIRS) after ureteroscopy

Yahşi

Ceviz

2023

The European Research Journal

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“…However, the reported UTI rate after specific endourology procedures is PCNL 17.5%, 9 TURP 14% 3 and URS 14.1%. 2 The symptomatic infection rates are reported at 5.8%-12.3%. 13,14 However, our symptomatic infections rates were 6.3%.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of overall post‐operative bacteriuria rate is 17.8% in our study. However, the reported UTI rate after specific endourology procedures is PCNL 17.5%, 9 TURP 14% 3 and URS 14.1% 2 . The symptomatic infection rates are reported at 5.8%–12.3% 13,14 .…”

Section: Discussionmentioning

confidence: 99%

“…Studies have demonstrated factors such as the presence of preoperative bacteriuria, 6 pre‐operative catheterization, 7 failure to use prophylactic antibiotics, 8 age, 9 operating time 10 and diabetes mellitus (DM), 11 as contributing to the development of post‐operative bacteriuria for specific endourological procedures. The rates of symptomatic bacteriuria in various frequently performed endourological procedures have been documented to be about 14.1% in ureterorenoscopy (URS), 2 about 34.9% in TURP, 11 and 30.7% in PCNL 12 . For the purpose of this study, we considered post‐operative bacteriuria as a positive urine culture (with or without symptoms) within 30 days of the endourological procedure.…”

Section: Introductionmentioning

confidence: 99%

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An analysis of bacteriuria rates after endourological procedures

Seenappa¹,

Sinha²,

Prasad³

et al. 2022

Int J of Uro Nursing

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Medical literature on infection rates for certain specific endourological procedures is available. However, literature is lacking in providing a comprehensive view of the overall post endoscopic infection rates and their risk factors. This article attempts to provide an understanding of overall bacteriuria rate and discuss the contributory factors for common endourological procedures performed in a dedicated urology unit. This was a retrospective analysis of all patients who underwent endourological procedures at our Institute between January 2019 and December 2019. The following factors were assessed as contributors to post-operative bacteriuria: gluteraldehyde versus plasma sterilization of endoscopic equipments, elective versus emergency procedures, age group, the presence of pre-operative foreign bodies, post-operative stent, chronic kidney disease (CKD), diabetes mellitus (DM), procedure time and American Society of Anaesthesiology (ASA) grades. The overall post-operative bacteriuria rate was 17.85% in our total study population, 6.37% had symptomatic urinary tract infection (UTI). Chronic kidney disease (OR 3.5, p < 0.003) and higher ASA grade (OR 1.92, P < 0.002) appear to confer the highest risk of bacteriuria. The factors which were associated with a trend towards a higher incidence of UTI without reaching statistical significance included: the use of gluteraldehyde versus plasma sterilization, pre-operative implants (Foley and ureteric stents), diabetes, advanced age, endoscopy time, post-operative stent emergency surgeries and a clinical decision against the use of prophylactic antibiotics. The overall rate of bacteriuria in all endourological procedures was 17.8%, 6.37% had symptomatic UTI. Chronic kidney disease and higher ASA grades were the most important contributing factors to develop post-operative bacteriuria.

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“…In another study by Mitsuzuka et al, it was stated that preoperative pyuria and acute pyelonephritis were important factors for post-URS fever [12]. In addition, various comorbidities such as diabetes mellitus have been shown to be a risk factor for post-URS fever [13]. In clinical practice, post-URS fever and SIRS can also be seen in patients with a clean urine culture and no history of pyelonephritis.…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of Preoperative High-Sensitive C-reactive Protein (hs-CRP)/Albumin Ratio in Systemic Inflammatory Response Syndrome (SIRS) After Semi-rigid Ureteroscopy

Kutluhan¹,

Ünal²,

Özayar³

et al. 2022

Cureus

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Objective: To determine the predictive value of high-sensitive C-reactive protein (hs-CRP)/albumin ratio in systemic inflammatory response syndrome (SIRS) after semi-rigid ureteroscopy (URS).Material and Methods: Between April 2021 and October 2021, 148 patients who had ureteral stone treatment with a ureteroscope in our hospital were included. Preoperative hs-CRP/albumin ratio was obtained by dividing the hs-CRP level by the albumin level. High-sensitivity modified Glasgow prognostic score (hs-mGPS) was obtained according to hs-CRP and albumin values. Two groups were identified as post-URS SIRS positive and negative. Inflammation biomarkers were evaluated in groups.Results: There was a statistically significant difference between groups in terms of preoperative hs-CRP, albumin, and hs-CRP/albumin ratio (p < 0.001, p = 0.003, and p < 0.001, respectively). The optimal cutoff value for the hs-CRP/albumin ratio was 0.04651. While the risk of developing SIRS after surgery was 72.73% in patients with a hs-CRP/albumin ratio higher than 0.04651, the chance of not developing SIRS was 87.5% in patients below this value. The probability of developing SIRS was found to be significantly different in hs-mGPS (p < 0.001). Conclusion:Our study indicated that hs-CRP/albumin ratio can predict post-URS SIRS. Larger-scale, multicentric prospective studies should certainly be done to validate the predictive value of hs-CRP/albumin ratio in post-URS SIRS.

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Clinical characteristics of postoperative febrile urinary tract infections after ureteroscopic lithotripsy in diabetics: How to predict?

Cited by 8 publications

References 0 publications

The systemic immune-inflammation index (SII) in predicting postoperative systemic inflammatory response syndrome (SIRS) after ureteroscopy

The systemic immune-inflammation index (SII) in predicting postoperative systemic inflammatory response syndrome (SIRS) after ureteroscopy

An analysis of bacteriuria rates after endourological procedures

Predictive Value of Preoperative High-Sensitive C-reactive Protein (hs-CRP)/Albumin Ratio in Systemic Inflammatory Response Syndrome (SIRS) After Semi-rigid Ureteroscopy

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