Risk of Systemic Inflammatory Response Syndrome Following Preoperative Glucocorticoids Administration in Patients After Percutaneous Nephrolithotomy: A Retrospective Cohort Study.

IF 4 2区医学 Q1 PHARMACOLOGY & PHARMACY

Drug Safety Pub Date : 2024-05-01 Epub Date: 2024-03-05 DOI:10.1007/s40264-024-01402-y

Jingping Hu, Chaojin Chen, Xiaoyue Li, Xiangyang Zang, Jie Ke, Shaoli Zhou, Haiyan Mai, Chulian Gong

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Abstract

Introduction: Systemic inflammatory response syndrome (SIRS) is one of the most serious complications in patients undergoing percutaneous nephrolithotomy (PCNL). Although glucocorticoids are increasingly used during PCNL, few studies have been concerned about the association between glucocorticoids and postoperative SIRS. The study aims to explore whether preoperative use of glucocorticoids is associated with SIRS after PCNL.

Methods: A total of 1259 patients who underwent PCNL between January 2015 and April 2021 were enrolled in the retrospective cohort study. Risk factors for post-PCNL SIRS were identified by univariate and multivariate regression analysis. To further explore the association between preoperative administration of glucocorticoids and SIRS, 113 pairs of patients were matched for the confounding factors using propensity score matching (PSM) analysis. The odds ratios (OR) and 95 % confidence intervals (CI) for the above variables were analyzed.

Results: The incidence of SIRS after PCNL was 9.6 % (121/1259) and the patients who suffered from postoperative SIRS had longer hospital stays and higher hospital costs (all p < 0.05). Multivariate logistic regression analysis indicated that female, preoperative leukocyte count, insertion of central vein catheter, serum albumin, preoperative high-sensitive C-reactive protein/albumin ratio, preoperative transfusion, preoperative administration of glucocorticoids were independent risk factors for SIRS (all p < 0.05). After minimization, the effects of confounding factors by PSM, preoperative administration of glucocorticoids was significantly correlated with SIRS in patients after PCNL (OR=2.44, 95 %CI: 1.31-4.55, p = 0.005).

Conclusion: Preoperative administration of glucocorticoids is an independent risk factor for SIRS in patients undergoing PCNL.

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经皮肾镜碎石术后患者术前使用糖皮质激素后出现全身炎症反应综合征的风险：一项回顾性队列研究

简介：全身炎症反应综合征（SIRS）是经皮肾取石术（PCNL）患者最严重的并发症之一。尽管 PCNL 期间越来越多地使用糖皮质激素，但很少有研究关注糖皮质激素与术后 SIRS 之间的关联。本研究旨在探讨术前使用糖皮质激素是否与 PCNL 术后 SIRS 相关：该回顾性队列研究共纳入了 2015 年 1 月至 2021 年 4 月间接受 PCNL 的 1259 例患者。通过单变量和多变量回归分析确定了 PCNL 术后 SIRS 的风险因素。为进一步探讨术前使用糖皮质激素与SIRS之间的关系，采用倾向评分匹配（PSM）分析法对113对患者进行了混杂因素匹配。分析了上述变量的几率比（OR）和95%置信区间（CI）：PCNL 术后 SIRS 的发生率为 9.6%（121/1259），术后 SIRS 患者的住院时间更长，住院费用更高（均 p < 0.05）。多变量逻辑回归分析表明，女性、术前白细胞计数、插入中心静脉导管、血清白蛋白、术前高敏 C 反应蛋白/白蛋白比值、术前输血、术前使用糖皮质激素是 SIRS 的独立危险因素（均 p < 0.05）。通过 PSM 尽可能减少混杂因素的影响后，PCNL 患者术前使用糖皮质激素与 SIRS 显著相关（OR=2.44，95 %CI：1.31-4.55，p = 0.005）：结论：术前使用糖皮质激素是 PCNL 患者发生 SIRS 的独立危险因素。

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来源期刊

Drug Safety 医学-毒理学

CiteScore

7.60

自引率

7.10%

发文量

112

审稿时长

6-12 weeks

期刊介绍： Drug Safety is the official journal of the International Society of Pharmacovigilance. The journal includes: Overviews of contentious or emerging issues. Comprehensive narrative reviews that provide an authoritative source of information on epidemiology, clinical features, prevention and management of adverse effects of individual drugs and drug classes. In-depth benefit-risk assessment of adverse effect and efficacy data for a drug in a defined therapeutic area. Systematic reviews (with or without meta-analyses) that collate empirical evidence to answer a specific research question, using explicit, systematic methods as outlined by the PRISMA statement. Original research articles reporting the results of well-designed studies in disciplines such as pharmacoepidemiology, pharmacovigilance, pharmacology and toxicology, and pharmacogenomics. Editorials and commentaries on topical issues. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in Drug Safety Drugs may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.