Assessing the Optimal Urine Culture for Predicting Systemic Inflammatory Response Syndrome After Percutaneous Nephrolithotomy and Retrograde Intrarenal Surgery: Results from a Systematic Review and Meta-Analysis

Castellani, Daniele; Teoh, Jeremy Yuen Chun; Pavia, Maria Pia; Pretore, Eugenio; Dell’Atti, Lucio; Galosi, Andrea Benedetto; Gauhar, Vineet

doi:10.1089/end.2021.0386

Cited by 12 publications

(8 citation statements)

References 33 publications

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“…In our current study, the optimal cut-off value of preoperative AGR for predicating SIRS after PCNL was found to be 1.145 with 83% sensitivity and 88.9% specificity and the AUC was 0.844, which showed a good diagnostic performance. Moreover, the AUC of AGR for predicting post-PCNL SIRS was also higher than many other previous indicators, such as NLR (reported with 0.596–0.831), 4 , 8 , 9 LMR (reported with 0.649–0.734), 8–10 PLR (reported with 0.617–0.685), 8–10 preoperative positive midstream urine culture (reported with 0.65) 29 and so on. Patients whose AGR <1.145 were found to be with lower serum ALB level, higher serum GLB level, higher urine white cell count, positive urine nitrite, positive urine culture, higher white blood cell count, higher neutrophil count and higher serum CRP level, so these patients are suggested to be carefully evaluated and treated before performing PCNL in the future.…”

Section: Discussionmentioning

confidence: 65%

The Predictive Value of Preoperative Albumin–Globulin Ratio for Systemic Inflammatory Response Syndrome After Percutaneous Nephrolithotomy

Wang¹,

Jiang²,

Chen³

et al. 2022

IJGM

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Purpose This study aimed to assess the predictive value of preoperative albumin–globulin ratio (AGR) for systemic inflammatory response syndrome (SIRS) after percutaneous nephrolithotomy (PCNL). Methods Patients who underwent PCNL in Guizhou Provincial People’s hospital between August 2017 and July 2019 were enrolled and retrospectively reviewed. The primary clinical outcome of the current study was the development of SIRS within 48h after PCNL. Univariable and multivariable logistic regression analyses were conducted to verify the predictive value of AGR for post-PCNL SIRS. In addition, receiver operating characteristic (ROC) curves were generated to compare the discriminatory ability of AGR with other inflammatory biomarkers. Results 354 patients who underwent PCNL were enrolled and 66 patients (18.64%) developed postoperative SIRS. None of the patients suffered postoperative sepsis in our study. Multivariate analysis demonstrated that female sex (odds ratio [OR]=2.939, 95% odds ratio [OR]: 1.368–6.315, p = 0.006), CRP (OR = 1.008, 95% CI: 1.003–1.012, p = 0.001), and AGR (OR = 0.048, 95% CI: 0.010–0.239, p < 0.001) were all independent predictors for SIRS after PCNL. The optimal cut-off value of AGR for predicting postoperative SIRS was 1.145. In addition, AGR had a higher area under the curve (0.844) with sensitivity of 83.3% and specificity of 88.9% than C-reactive protein (0.808). Conclusion Preoperative AGR is a potential predictor for SIRS development after PCNL.

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Section: Discussionmentioning

confidence: 65%

The Predictive Value of Preoperative Albumin–Globulin Ratio for Systemic Inflammatory Response Syndrome After Percutaneous Nephrolithotomy

Wang¹,

Jiang²,

Chen³

et al. 2022

IJGM

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“…In our study, the incidence of emergency surgical intervention in females, associated also with infectious complications, was found to be higher (75.3% vs 68.1%), but this was not statistically significant ( p = 0.1). Castellani et al 14 observed that the best method to collect urine was above the obstructing stone, however, voiding urine culture was noted to be of paramount importance to avoid an ascending infection during ureteroscopy. Based on this data, we believe that in the female population, adding antibiotic treatment to MET may be warranted.…”

Section: Discussionmentioning

confidence: 99%

Effect of gender on presentation and outcome of renal colic

Golomb¹,

Shemesh²,

Goldberg

et al. 2023

Urologia

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Objectives: To examine gender-related differences in the presentation, management, and outcomes of patients admitted to the emergency department ED with ureteral stones. Methods: Retrospective analysis of all patients admitted to the ED at our institution, found to have a ureteral stone on CT. Clinical, laboratory, imaging parameters, and outcomes were collected. Results: 778 patients were admitted with ureteral stones between January 2018 and December 2020. 78% ( n = 609) were males and 22% ( n = 169) were females. The mean ages were 49.4 (SD 14.4) and 51.6 (SD 15.7) in males and females, respectively ( p = 0.08). Female patients presented with a higher body temperature ( p = 0.01), pulse rate ( p < 0.0001), nausea and vomiting ( p < 0.0001), elevated serum C-reactive protein (CRP) ( p = 0.002) compared to males. The prevalence of elevated serum creatinine was higher in males ( p < 0.0001). Alpha-blockers were recommended on discharge in 54.8% (334) of males, compared to only 29.6% (50) of females ( p < 0.0001). Spontaneous stone expulsion was significantly higher in males compared to females ( p = 0.01). Conclusions: Our results demonstrate that gender does effect presentation and outcome of patients presenting with renal colic. Females were found to have elevated infectious parameters, more nausea and vomiting and a higher incidence of positive urine cultures. Males admitted to the ED were found to have significantly higher serum creatinine levels. Medical expulsive therapy (MET) with alpha-blockers was prescribed significantly less in female patients, which may have resulted in a lower spontaneous stone expulsion rate.

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“…Zhou et al [5] found through a systematic review and meta-analysis of 18 studies, including more than 7000 patients that the infectious complication risk post-PCNL is as high as 40.4%. One confounding issue making prevention of post-PCNL infection difficult is that preoperative midstream urine culture has been shown to be poorly reliable for predicting systemic inflammatory response syndrome (SIRS) [6,7 ▪▪ ]. Renal pelvis urine culture, and more so stone culture, are more predictive of SIRS [6] with culture specificity and should be collected routinely.…”

Section: Infectionmentioning

confidence: 99%

“…One confounding issue making prevention of post-PCNL infection difficult is that preoperative midstream urine culture has been shown to be poorly reliable for predicting systemic inflammatory response syndrome (SIRS) [6,7 ▪▪ ]. Renal pelvis urine culture, and more so stone culture, are more predictive of SIRS [6] with culture specificity and should be collected routinely. However, Tzou et al [8] found that Endourologists have significantly differing practice patterns, with 32% of fellowship-trained Endourologists reporting that stone cultures are not accessible to them and only able to order urine cultures collected during stone procedures.…”

Section: Infectionmentioning

confidence: 99%

Percutaneous management of upper tract stones: from mini to maxi percutaneous nephrolithotomy

Stern¹

2023

Current Opinion in Urology

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Purpose of reviewPercutaneous nephrolithotomy (PCNL) continues as the gold standard for the surgical management of large renal stones. This short review is intended to highlight recent publications on PCNL of all tract sizes, from mini to standard. Recent findingsLiterature on PCNL in the last 2 years has focused on several main themes --decreasing complications, improving postoperative pain control, and new technology to improve outcomes. Mini-PCNL continues to prove effective and safe, with a new vacuum sheath showing promise of improving stone-free rates and decreasing infections. In terms of infections, preoperative midstream urine culture continues to be a poor indicator of postoperative infection. One of the biggest changes to PCNL practice is the reintroduction of tranexamic acid, which has shown to significantly decrease bleeding and improve outcomes. In terms of postoperative pain control, local blocks are effective and low risk.

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Assessing the Optimal Urine Culture for Predicting Systemic Inflammatory Response Syndrome After Percutaneous Nephrolithotomy and Retrograde Intrarenal Surgery: Results from a Systematic Review and Meta-Analysis

Cited by 12 publications

References 33 publications

The Predictive Value of Preoperative Albumin–Globulin Ratio for Systemic Inflammatory Response Syndrome After Percutaneous Nephrolithotomy

The Predictive Value of Preoperative Albumin–Globulin Ratio for Systemic Inflammatory Response Syndrome After Percutaneous Nephrolithotomy

Effect of gender on presentation and outcome of renal colic

Percutaneous management of upper tract stones: from mini to maxi percutaneous nephrolithotomy

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