Analysis of Risk Factors for Urosepsis in Patients with Type 2 Diabetes Complicated by Upper Urinary Tract Stones: A Single-Centre Retrospective Study.

IF 0.6 4区医学 Q4 UROLOGY & NEPHROLOGY

Archivos Espanoles De Urologia Pub Date : 2024-09-01 DOI:10.56434/j.arch.esp.urol.20247708.123

Xiaomin Yang, Chunyan Lang

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引用次数: 0

Abstract

Background: Urosepsis represents a complication of upper urinary tract stones (UUTSs) in patients with type 2 diabetes mellitus (T2DM), thus necessitating a comprehensive understanding of risk factors. This single-centre retrospective study aimed to analyse the risk factors for urosepsis in this patient population.

Methods: Clinical data of patients with UUTS and T2DM admitted from January 2015 to January 2024 were collected and retrospectively analysed. Laboratory parameters, including white blood cell (WBC) count, serum creatinine, urine culture, C-reactive protein and imaging findings were assessed. Stepwise backward selection and logistic regression analysis was used to explore the risk factors of urosepsis.

Results: A total of 108 patients, including 56 patients complicated with urosepsis and 52 without urosepsis, were included. The urosepsis group exhibited significantly increased white blood cell count (15.75 ± 2.58 vs. 14.63 ± 2.76, p = 0.031), colony-forming units per millilitre in urine culture (5000.46 ± 1200.56 vs. 4570.13 ± 1000.24, p = 0.045), serum C-reactive protein levels (43.02 ± 12.36 vs. 38.54 ± 10.75, p = 0.047), presence of hydronephrosis (82.14% vs. 63.46%, p = 0.049) , ureteral stricture (46.43% vs. 25.00%, p = 0.034), prevalence of Gram-negative bacteria (85.71% vs. 67.31%, p = 0.042), antibiotic resistance (37.50% vs. 17.31%, p = 0.034), and empirical antibiotic use (62.50% vs. 40.38%, p = 0.035) compared with the non-urosepsis group. Gram-negative bacteria (odds ratio (OR) = 2.914, p = 0.027), antibiotic resistance (OR = 2.867, p = 0.022), renal hydronephrosis (OR = 2.648, p = 0.031), urethral stricture (OR = 2.600, p = 0.022) and antibiotic usage history (OR = 2.460, p = 0.023) exhibited significant OR values, whereas white blood cell (WBC) count demonstrated a moderate OR value (OR = 1.175, p = 0.034). These findings further underscore their potential to be reasonably predictive risk factors for urosepsis.

Conclusions: This study identified various risk factors associated with urosepsis in patients with T2DM and UUTS. Laboratory parameters, imaging findings and urinary tract infection characteristics were found to be significant contributors to the development of urosepsis in this patient population.

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上尿路结石并发 2 型糖尿病患者尿崩症风险因素分析：单中心回顾性研究

背景：尿崩症是2型糖尿病（T2DM）患者上尿路结石（UUTS）的一种并发症，因此需要全面了解风险因素。这项单中心回顾性研究旨在分析这一患者群体中尿路结石的风险因素：收集并回顾性分析了 2015 年 1 月至 2024 年 1 月期间收治的尿崩症和 T2DM 患者的临床数据。评估实验室参数，包括白细胞（WBC）计数、血清肌酐、尿培养、C反应蛋白和影像学检查结果。采用逐步后向选择和逻辑回归分析法探讨尿毒症的风险因素：结果：共纳入108例患者，包括56例尿毒症并发症患者和52例无尿毒症患者。尿毒症组的白细胞计数（15.75 ± 2.58 vs. 14.63 ± 2.76，P = 0.031）、每毫升尿培养菌落形成单位（5000.46 ± 1200.56 vs. 4570.13 ± 1000.24，P = 0.045）、血清 C 反应蛋白水平（43.02 ± 12.36 vs. 38.54 ± 10.75，P = 0.047）、肾积水（82.14% vs. 63.46%，P = 0.049）、输尿管狭窄（46.43% vs. 25.00%，P = 0.034）、革兰氏阴性菌感染率（85.71% vs. 67.31%，p = 0.042）、抗生素耐药性（37.50% vs. 17.31%，p = 0.034）和经验性抗生素使用（62.50% vs. 40.38%，p = 0.035）。革兰氏阴性菌（比值比 (OR) = 2.914，P = 0.027）、抗生素耐药性（OR = 2.867，P = 0.022）、肾积水（OR = 2.648，P = 0.031）、尿道狭窄（OR = 2.600，P = 0.022）和抗生素使用史（OR = 2.460，P = 0.023）显示出显著的 OR 值，而白细胞（WBC）计数显示出中等程度的 OR 值（OR = 1.175，P = 0.034）。这些发现进一步表明，它们有可能成为尿毒症的合理预测风险因素：本研究发现了 T2DM 和尿崩症患者中与尿崩症相关的各种风险因素。结论：本研究确定了与 T2DM 和 UUTS 患者尿毒症相关的各种风险因素，发现实验室参数、影像学检查结果和尿路感染特征是导致这类患者发生尿毒症的重要因素。

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来源期刊

Archivos Espanoles De Urologia UROLOGY & NEPHROLOGY-

CiteScore

0.90

自引率

0.00%

发文量

111

期刊介绍： Archivos Españoles de Urología published since 1944, is an international peer review, susbscription Journal on Urology with original and review articles on different subjets in Urology: oncology, endourology, laparoscopic, andrology, lithiasis, pediatrics , urodynamics,... Case Report are also admitted.