Risk factors for urosepsis following ureteroscopic lithotripsy: a systematic review and meta-analysis.

IF 1.6 4区医学 Q2 SURGERY

Frontiers in Surgery Pub Date : 2025-06-19 eCollection Date: 2025-01-01 DOI:10.3389/fsurg.2025.1603311

Lifei Dai, Junlian Xiang, Xiaoli Liu, Xiaoyan Wen, Lin Tan, Jiali Zhang

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引用次数: 0

Abstract

Background: Ureteroscopic lithotripsy (URSL) is the preferred treatment for urinary tract stones, with urosepsis being its most severe postoperative complication. Although previous studies have investigated risk factors for urosepsis after URSL, significant variations exist in reported risk factors and their associated odds ratios (OR), leading to inconsistent findings across studies. This systematic review and meta-analysis investigated the risk factors for urosepsis after URSL, aiming to establish a scientific foundation for early clinical identification and to reduce the incidence and mortality of this complication.

Methods: Case-control and cohort studies on factors influencing urosepsis after URSL were systematically retrieved from major public medical databases, including PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Data, and Chinese Science and Technology Journal Database, up to January 31, 2025. Two researchers independently conducted literature screening, data extraction, quality assessment, and meta-analysis using Stata versions 15.1 and 18.0.

Results: A total of 26 studies were included in this analysis, comprising 12,394 patients, of whom 861 patients developed urosepsis. The influencing factors for urosepsis included stone size[OR = 3.10, 95% CI (1.20,8.00), P = 0.002], number of stones [OR = 7.59, 95% confidence interval (CI): 3.82, 15.08; P < 0.001], history of urinary tract infection (OR = 5.96, 95% CI: 4.12, 8.60; P < 0.001), positive urine culture (OR = 4.95, 95% CI: 3.90, 6.28; P < 0.001), positive urinary nitrite (OR = 7.68, 95% CI: 1.03, 52.27; P = 0.047], C-reactive protein (OR = 4.3, 95% CI: 1.06, 17.49; P = 0.042), diabetes (OR = 3.60, 95% CI: 3.11, 4.16; P < 0.001), operation time (OR = 1.09, 95% CI: 1.07, 1.11; P < 0.001), and stent placement (OR = 3.71, 95% CI: 1.94, 7.09; P < 0.001].

Conclusion: Urosepsis following URSL is associated with a high mortality rate and significantly threatens patient safety and quality of life. Early identification of the factors influencing urosepsis is crucial to reduce its incidence and improve patient outcomes.

Systematic review registration: PROSPERO CRD42025641787.

查看原文本刊更多论文

输尿管镜碎石术后尿脓毒症的危险因素：一项系统回顾和荟萃分析。

背景：输尿管镜碎石术（URSL）是治疗尿路结石的首选方法，尿脓毒症是其术后最严重的并发症。虽然之前的研究已经调查了URSL后尿脓毒症的危险因素，但报道的危险因素及其相关的比值比（OR）存在显著差异，导致研究结果不一致。本系统综述和荟萃分析旨在探讨URSL术后尿脓毒症的危险因素，为临床早期识别提供科学依据，降低URSL并发症的发生率和死亡率。方法：系统检索截至2025年1月31日的主要公共医学数据库，包括PubMed、Web of Science、Embase、Cochrane图书馆、中国知网、万方数据、中国科技期刊库等，对URSL术后尿脓毒症影响因素的病例对照和队列研究。两位研究者使用Stata 15.1和18.0版本独立进行文献筛选、数据提取、质量评估和meta分析。结果：本分析共纳入26项研究，包括12394例患者，其中861例患者发生尿脓毒症。尿脓毒症的影响因素包括结石大小[OR = 3.10, 95% CI (1.20,8.00), P = 0.002]、结石数量[OR = 7.59, 95%可信区间（CI）： 3.82, 15.08；P P P P = 0.047), c反应蛋白(OR = 4.3, 95% CI: 1.06, 17.49;P = 0.042)、糖尿病(OR = 3.60, 95% CI: 3.11, 4.16;结论：URSL后尿脓毒症死亡率高，严重威胁患者安全和生活质量。早期识别影响尿脓毒症的因素对于降低其发病率和改善患者预后至关重要。系统评价注册：PROSPERO CRD42025641787。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Surgery Medicine-Surgery

CiteScore

1.90

自引率

11.10%

发文量

1872

审稿时长

12 weeks

期刊介绍： Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles. Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery. Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact. The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.