Emergency decompression for patients with ureteral stones and SIRS: a prospective randomized clinical study

Lu, Xiaofei; Zhou, Benzheng; Hu, Dechao; Ding, Yanting

doi:10.1080/07853890.2023.2169343

Cited by 3 publications

(2 citation statements)

References 27 publications

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“…The management of UROP is warranted by urgent decompression, which can be achieved either by PCN or ureteral stent placement, thereby decreasing complications in high-risk patients [30]. One meta-analysis showed no significant difference between the two methods regarding the improvement of septic parameters, quality of life, failure rates, or post-procedural pain [31].…”

Section: Discussionmentioning

confidence: 99%

Development of a predictive nomogram for sepsis in patients with urolithiasis-related obstructive pyelonephritis

Tsai,

Huang,

Niu

et al. 2024

Preprint

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Background: In patients with urolithiasis-related obstructive pyelonephritis (UROP), sepsis represents a critical and concerning complication that can substantially increase the mortality rate. This study aimed to identify the risk factors for sepsis in UROP patients and to develop a predictive nomogram model. Methods: We analyzed data from 148 patients who met the UROP criteria and were admitted to Chang Gung Memorial Hospital between January 1, 2016, and December 31, 2021. The primary outcome evaluated was the incidence of sepsis, as defined by the most recent Sepsis-3 guidelines. To identify potential risk factors for sepsis, we employed the Least Absolute Shrinkage and Selection Operator (LASSO) regression technique. Subsequently, we utilized multivariable logistic regression to construct the predictive model. Results: There were a total of 102 non-sepsis cases and 46 sepsis cases. The sepsis group showed significantly lower systolic blood pressure (p < 0.001), a higher heart rate (p = 0.002), a higher shock index (SI) (p < 0.001), a more prevalent history of diabetes mellitus (DM) (p = 0.015), and the mean hospital length of stay was significantly longer (p < 0.001). The laboratory results indicated a higher rate of positive blood culture in the sepsis group (60.9% vs 33.3%, p = 0.002), increased serum white blood cell counts (17.2 ± 10.9 103/uL vs 12.8 ± 6.4 103/uL, p = 0.014), a higher proportion of bandemia (26.1% vs 4.1%, p < 0.001), elevated CRP levels (19.9 ± 9.8 mg/dL vs 9.9 ± 9.9 mg/dL, p < 0.001), and a higher neutrophil to lymphocyte ratio (NLR) (23.6 ± 20.3 vs 12.9 ± 10.1, p < 0.001). Risk factors for sepsis in multivariable analysis were a history of DM (OR = 4.24, p = 0.007), SI (x10-1) (OR = 1.55, p < 0.001), CRP (mg/dL) (OR = 1.08, p = 0.005), and NLR (x10) (OR = 1.58, p = 0.007). Conclusions: Our study demonstrated that patients with UROP who have DM, higher SI, higher NLR, and elevated CRP levels are significantly more likely to develop sepsis. These insights may aid in risk stratification, and it is imperative that clinicians promptly initiate treatment for those identified as high risk.

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Section: Discussionmentioning

confidence: 99%

Development of a predictive nomogram for sepsis in patients with urolithiasis-related obstructive pyelonephritis

Tsai,

Huang,

Niu

et al. 2024

Preprint

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“…While this interval is sufficient for majority of patients, previous studies have shown that there is an increasing incidence of Emergency Department visits for acute PCN exchanges, resulting in increased economic burdens on these patients and the health system. 10…”

Section: Introductionmentioning

confidence: 99%

Impact of drainage catheter material, size, and anti-dislodgement mechanism on percutaneous nephrostomy exchange intervals: a systematic review protocol

Iyer,

Konstantinidis,

et al. 2023

F1000Res

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Background: Percutaneous nephrostomy (PCN) is a commonly performed procedure by interventional radiology and urology to treat urinary obstruction. In this procedure, a catheter is percutaneously placed into the renal pelvis for urinary diversion or hemorrhagic cystitis. Material type, catheter size, and catheter shape (anti-dislodgement feature) ultimately contribute to the inherent traits of longevity in drainage catheter device. Reviewing the relative strengths or weaknesses of products in the existing clinical market may help clinicians critically appraise the devices they use with evidence-based findings from this review. Furthermore, a deeper understanding of the relative strengths and weaknesses of existing devices may help inform the next generation of drainage catheter devices to prolong the interval between exchanges without detriment to patient safety. Methods: The following electronic databases will be queried: PubMed, Web of Science, Cochrane from their inception to January 2023 to identify randomized controlled trials (RCTs) and cohort studies to investigate the differences that our interventions of catheter material, size, and dislodgement mechanism will have on the exchange interval (standard of care 90 days vs. 60 days vs. 45 days vs. 30 days). The primary outcomes will be the drainage catheter exchange frequency. Ethics and dissemination: We aim to share our findings through high-impact peer reviewed journals. As drainage catheters and minimally invasive interventional radiology procedures become more popular, it is important for healthcare providers taking case of these populations to understand which variables might optimize patient care and minimize emergent exchanges. Data will be made available to readers. Registration: PROSPERO (CRD42023432788, 16 June 2023).

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Development of a Predictive Nomogram for Sepsis in Patients with Urolithiasis-Related Obstructive Pyelonephritis

Tsai,

Huang,

Niu

et al. 2024

Medicina

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Background and Objectives: In patients with urolithiasis-related obstructive pyelonephritis (UROP), sepsis represents a critical and concerning complication that can substantially increase the mortality rate. This study aimed to identify the risk factors for sepsis in UROP patients and to develop a predictive nomogram model. Materials and Methods: We analyzed data from 148 patients who met the UROP criteria and were admitted to Chang Gung Memorial Hospital between 1 January 2016 and 31 December 2021. The primary outcome evaluated was the incidence of sepsis, as defined by the most recent Sepsis-3 guidelines. To identify potential risk factors for sepsis, we employed the Least Absolute Shrinkage and Selection Operator (LASSO) regression technique. Subsequently, we utilized multivariable logistic regression to construct the predictive model. Results: There was a total of 102 non-sepsis cases and 46 sepsis cases. Risk factors for sepsis in multivariable analysis were a history of diabetes mellitus (DM) (OR = 4.24, p = 0.007), shock index (SI) (×10−1) (OR = 1.55, p < 0.001), C-reactive protein (CRP) (mg/dL) (OR = 1.08, p = 0.005), and neutrophil to lymphocyte ratio (NLR) (×10) (OR = 1.58, p = 0.007). The nomogram exhibited an area under the receiver operating characteristic curve of 0.890 (95% CI 0.830–0.949). Conclusions: Our study demonstrated that patients with UROP who have DM, higher SI, higher NLR, and elevated CRP levels are significantly more likely to develop sepsis. These insights may aid in risk stratification, and it is imperative that clinicians promptly initiate treatment for those identified as high risk.

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Emergency decompression for patients with ureteral stones and SIRS: a prospective randomized clinical study

Cited by 3 publications

References 27 publications

Development of a predictive nomogram for sepsis in patients with urolithiasis-related obstructive pyelonephritis

Development of a predictive nomogram for sepsis in patients with urolithiasis-related obstructive pyelonephritis

Impact of drainage catheter material, size, and anti-dislodgement mechanism on percutaneous nephrostomy exchange intervals: a systematic review protocol

Development of a Predictive Nomogram for Sepsis in Patients with Urolithiasis-Related Obstructive Pyelonephritis

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