Can we predict postoperative fever and urinary tract ınfection after retrograde ıntrarenal surgery? Results of a case control matching multicentric RIRSearch study group.

IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY
Murat Akgül, Oktay Özman, Cem Başataç, Hakan Çakır, Önder Çınar, Mehmet Fatih Şahin, Fatih Şimşekoğlu, Kerem Teke, Duygu Sıddıkoğlu, Cenk Murat Yazıcı, Eyüp Burak Sancak, Barbaros Başeskioğlu, Haluk Akpınar, Bülent Önal
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Abstract

Purpose: Postoperative fever (POF)/urinary tract infection (UTI) is one of the most unpleasant and undesirable conditions for surgeons after retrograde intrarenal surgery (RIRS). RIRS is not recommended for any patient with a positive urine culture to avoid POF and UTI, but some patients may develop postoperative UTI even if the urine culture is sterile. This study investigated the predictive factors of fever and UTIs after RIRS.

Methods: In total, 1240 patients who underwent RIRS for proximal ureteral stones and/or kidney stones were analyzed. After case-control matching, 168 patients were included in the study. Demographic data, preoperative/peroperative/postoperative data, and hematological parameters were compared. Patients with sterile urine cultures were included in the study. Postoperative fever was defined as fever ≥ 38 °C within 72 h after RIRS. Patients were divided into two groups: those with and without POF/UTI. Demographic data, preoperative and postoperative findings, and inflammatory parameters of the patients were compared retrospectively.

Results: POF/UTI was observed in 61 (36.3%) of 168 patients who underwent RIRS. After case-control matching, increased body mass index (BMI) and longer operation time were found to be significant predictors of POF/UTI (p = 0.001 and 0.016 respectively). Preoperative systemic immune-inflammation index (SII) (PxN/L), high Platelet/Lymphocyte Ratio (PLR), and urine leukocyte positivity were found to be significant predictors of POF/UTI (p = 0.037, 0.025 and 0.038 respectively).

Conclusion: Hematological parameters are simple and feasible to use to evaluate POF/UTI in patients undergoing RIRS. High SII and PLR may predict POF and early infection after RIRS. In addition, according to demographic data and per-operative status, high BMI and prolonged operation time are risk factors for infection.

我们能否预测逆行ıntrarenal手术后的术后发热和尿路ınfection ?病例对照匹配多中心RIRSearch研究组结果。
目的:术后发热(POF)/尿路感染(UTI)是逆行肾内手术(RIRS)后外科医生最不愉快和不希望出现的情况之一。为了避免POF和尿路感染,不建议任何尿培养阳性的患者使用RIRS,但即使尿培养是无菌的,一些患者也可能发生术后尿路感染。本研究探讨呼吸道感染后发热和尿路感染的预测因素。方法:共分析了1240例输尿管近端结石和/或肾结石行RIRS的患者。经病例对照匹配,168例患者纳入研究。比较人口学资料、术前/术中/术后资料和血液学参数。无菌尿培养患者被纳入研究。术后发热定义为RIRS术后72 h内发热≥38°C。患者分为两组:有和没有POF/UTI。回顾性比较两组患者的人口学资料、术前、术后表现及炎症参数。结果:168例RIRS患者中有61例(36.3%)出现POF/UTI。病例对照匹配后,体重指数(BMI)升高和手术时间延长是POF/UTI的显著预测因子(p分别= 0.001和0.016)。术前全身免疫炎症指数(SII) (PxN/L)、高血小板/淋巴细胞比(PLR)和尿白细胞阳性是POF/UTI的显著预测因子(p分别为0.037、0.025和0.038)。结论:血液学参数用于RIRS患者POF/UTI的评价简单可行。高SII和PLR可预测RIRS后的POF和早期感染。此外,根据人口统计学资料和术前情况,BMI高和手术时间延长是感染的危险因素。
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来源期刊
World Journal of Urology
World Journal of Urology 医学-泌尿学与肾脏学
CiteScore
6.80
自引率
8.80%
发文量
317
审稿时长
4-8 weeks
期刊介绍: The WORLD JOURNAL OF UROLOGY conveys regularly the essential results of urological research and their practical and clinical relevance to a broad audience of urologists in research and clinical practice. In order to guarantee a balanced program, articles are published to reflect the developments in all fields of urology on an internationally advanced level. Each issue treats a main topic in review articles of invited international experts. Free papers are unrelated articles to the main topic.
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