Risk factors for progression of Urolith Associated with Obstructive Urosepsis to severe sepsis or septic shock

Abstract

Introduction To analyze the risk factors for progression of urolith associated with obstructive urosepsis to severe sepsis or septic shock, we had done the retrospective cross-sectional study, which would facilitate the early identification of high-risk patients. Materials and methods Datas were retrospectively reviewed from 160 patients, suffering from obstructive urosepsis associated with urolith between December 2013 and December 2019. There were 49 patients complicating by severe sepsis (severe sepsis group), 12 patients complicating by septic shock (septic shock group), and 99 patients without progressing to severe sepsis or septic shock (sepsis group). The data covered age, gender, BMI (body mass index), time interval from ED (emergency department) to admission, WBC count (white blood cell count), NLR (neutrophil/lymphocyte ratio), HGB (hemoglobin), etc. Datas were analyzed by univariate analyses and multivariate logistic regression analysis. The corresponding nomogram prediction model was drawn according to the regression coefficients. Results Univariate analysis showed that the differences of age, the time interval from ED to admission, history of diabetes mellitus, history of CKI (chronic kidney disease), NLR, HGB, platelet count, TBil (total bilirubin), SCr (serum creatinine), ALB (albumin), PT (prothrombin time), APTT (activated partial thromboplastin time), INR (international normalized ratio), PCT (procalcitonin), and positive rate of pathogens in blood culture were statistically significant (P < 0.05). Multivariatelogistic regression analysis showed that age, SCr, and history of CKI were independent risk factors for progression to severe sepsis, or septic shock (P < 0.05). Conclusions Aged ≥ 65 years, SCr ≥ 248 mol/L, and history of CKI were independent risk factors for progression of urolith associated with obstructive urosepsis to severe sepsis or septic shock. We need to pay more attention to these aspects, when coming across the patients with urolithic sepsis.

Machine learning-based prediction of septic shock in patients with obstructive pyelonephritis caused by ureteral stones

“…Notably, these three variables are generally included in routine investigations. The present study included most of the factors that were identi ed to be signi cant in the relevant previous studies [1][2][3][4][5][6][7][8][9][10][20][21][22][23][24][25]. However, we excluded lactate and ABGA levels from the analysis as they were already included in the Sepsis-3 diagnostic criteria [19].…”

Risk factors of concurrent urinary sepsis in patients with diabetes mellitus comorbid with upper urinary tract calculi

“…With the increase of age, the functions of various organs or systems tend to decline, including liver and kidney dysfunction, cardiovascular system defects, and immune system defects[ 23 ]. Weakened compensatory ability of organs and systems in patients gives rise to a decline in overall physical function, and patients with DM are more susceptible to infection in such cases[ 24 ].…”

Sepsis risk in diabetic patients with urinary tract infection

“…A delay of one hour in the administration of antibiotics for urinary-derived sepsis was reportedly associated with a reduction in patient survival rate by 7.6% [ 8 ].Therefore, the incidence of sepsis may be reduced by implementing timely risk assessment and appropriate antibiotic therapy. There are literature reports on the identification of risk factors for progression to sepsis in patients with different diseases [ 9 , 10 ], but there are few reports on progression to sepsis in patients with diabetes mellitus complicated with UTI. Hence, our objective was to ascertain certain indications that might be used to promptly identify the distinguishing features of diabetic individuals with UTI exacerbated by sepsis.…”