Early Drastic Decrease in White Blood Count Can Predict Uroseptic Shock Induced by Upper Urinary Tract Endoscopic Lithotripsy: A Translational Study

Wu, Haiyang; Zhu, Shibin; Yu, Shicheng; Ding, Guoqing; Xu, Jun; Li, Tao; Qiao, Lili; Chen, Yue; Yan, Jiajun; Cheng, Xin; Wan, Shaw P.; Li, Gonghui

doi:10.1016/j.juro.2015.01.071

Cited by 20 publications

(25 citation statements)

References 21 publications

(17 reference statements)

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“…In terms of surgery, a number of studies have reviewed the risk factors for the occurrence of postoperative sepsis and mortality following endourological treatment: Presence of kidney stones; large stone burden; female sex; diabetes mellitus; renal insufficiency; high pressure in the collecting system; and long surgery times were identified to be risk factors for sepsis following operation (9)(10)(11)30). Wu et al (12) demonstrated an association between the early marked decrease in WBC count and uroseptic shock induced by upper urinary tract endoscopic lithotripsy. However, there was no unified, widely accepted and standardized criteria for predicting the prognosis of these patients.…”

Section: Discussionmentioning

confidence: 99%

“…Surgical procedure. The methods used to perform PCNL, URL and emergency ureteroscopic double J stenting procedures were analogous with other previously described methods (11,12,23). Patients with obstructive urolithiasis and suspected urosepsis, as diagnosed by the emergency physicians, were transferred to the urology department.…”

Section: Methodsmentioning

confidence: 99%

“…Urosepsis is defined as sepsis caused by a urogenital tract infection and it may be caused by urinary tract obstruction or complication following surgical interventions (6)(7)(8). Urolithiasis-associated sepsis, caused by obstructive upper ureteral calculi or postoperative complications following percutaneous nephrolithotomy (PCNL), ureteroscopic lithotripsy (URL) and laparoscopic lithotomy, is a severe global problem in the field of urology (9)(10)(11)(12)(13). To the best of our knowledge, there is no consensus on whether the Sepsis-3 criteria are an effective prognostic tool for patients with urolithiasis-associated sepsis.…”

Section: Introductionmentioning

confidence: 99%

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The prognostic performance of Sepsis‑3 and SIRS criteria for patients with urolithiasis‑associated sepsis transferred to ICU following surgical interventions

Shi

et al. 2019

Exp Ther Med

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The aim of the present study was to validate the prognostic effectiveness of Sepsis-3 criteria, including sequential organ failure assessment (SOFA) and quick SOFA (qSOFA), with systemic inflammatory response syndrome (SIRS) criteria among patients with urolithiasis associated sepsis that were transferred to intensive care unit (ICU) facilities following surgical interventions. To achieve this, the records of all patients transferred to ICU following surgical interventions with urolithiasis-associated sepsis between January 2010 to July 2017 at Xin Hua Hospital Affiliated to Shanghai Jiao Tong University were retrospectively reviewed. A total of 107 patients were enrolled. The prognostic performances of SOFA, qSOFA and SIRS for predicting in-hospital mortality (sepsis-related mortality during patients' hospitalizations) or prolonged length of ICU stay (>3 days) were compared using the area under the receiver operating characteristic curve (AUROC) and Z statistic values. The results revealed that the overall in-hospital mortality rate was 8.4% and the percentage of in-hospital mortality or prolonged length of ICU stay (>3 days) was 72.0% among the 107 patients. The favorable outcome group exhibited significantly decreased white blood cell counts, and levels of C-reactive protein and procalcitonin and increased systolic blood pressure and mean arterial pressure. The AUROC of qSOFA, SIRS and SOFA were 0.615, 0.625 and 0.860, respectively. SOFA was significantly more effective at predicting adverse outcomes when compared with SIRS and qSOFA criteria. Following adjustments for patient age and comorbidities, the AUROC values of qSOFA, SIRS and SOFA were 0.713, 0.722 and 0.940. In conclusion, the results of the present study indicate that the prognostic performance of SOFA for predicting in-hospital mortality or prolonged ICU stay among patients with urolithiasis-associated sepsis following surgical interventions was significantly improved when compared with qSOFA or SIRS criteria. Based on these results it is recommended that urologists use the SOFA score for patients with urolithiasis-associated sepsis.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The prognostic performance of Sepsis‑3 and SIRS criteria for patients with urolithiasis‑associated sepsis transferred to ICU following surgical interventions

Shi

et al. 2019

Exp Ther Med

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“…Wu et al (page 2116) from the People's Republic of China identified a practical predictor of UUTEL induced uroseptic shock in a rabbit model and validated results by retrospectively reviewing multicenter clinical records. 3 They ligated rabbit ureters and injected Escherichia coli solution in the renal pelvis to create the uroseptic shock model. White blood count (WBC) and other parameters were measured at different bacterial concentrations and intervals.…”

Section: Decreased White Blood Count Predicts Uroseptic Shock After Lmentioning

confidence: 99%

This Month in Investigative Urology

Andersson¹

2015

Journal of Urology

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“…During PCNL for staghorn calculi, blood loss is significantly increased compared with that occurring in this procedure for other types of stone (6). Urosepsis after upper urinary tract endoscopic surgery is a life-threatening complication and considered to be associated with high intrapelvic pressure and large stone size (7). In addition, it remains controversial which procedures are best for patients with staghorn renal stone and concurrent urinary tract infection (UTI).…”

Section: Introductionmentioning

confidence: 99%

Management of unilateral staghorn renal stones with concurrent urinary tract infections by retroperitoneal laparoscopic pyelolithotomy with prolonged renal posterior lower segment incision

Shi

Hong

2019

Exp Ther Med

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The present study evaluated the effectiveness and safety of the removal of unilateral staghorn renal stones with concurrent infections by retroperitoneal laparoscopic pyelolithotomy (RLP) with prolonged renal posterior lower segment incision. Patients with staghorn renal stone and concurrent urinary tract infection (UTI) who underwent RLP with prolonged renal posterior lower segment incision as the primary, one-session treatment at our institution between March 2014 and December 2017 were retrospectively reviewed. Routine laboratory tests were performed and the patients received broad-spectrum intravenous antibiotics from at least 3 days prior to the operation. All patients were examined pre-operatively by urinary ultrasonography, computed tomography or intravenous urography. UTI was confirmed by laboratory tests with or without radiographic evidence by an experienced urologist. All patients (18 females and 10 males) successfully underwent the procedures and there was no conversion to open surgery in any case. The mean age was 57.0±10.81 years (age range, 40–74 years) and the mean calculus size was 3.3±0.79 cm. The mean operation time, warm ischemia time and post-operative hospital stay were 114.4±12.09 min, 28.1±4.23 min and 5.8±1.42 days, respectively. The mean hemoglobin drop on day 3 following surgery was 0.5±0.38 g/dl and there was no requirement for blood transfusion in any patient. The mean change of serum creatinine levels between pre-operative baseline and post-operative day 3 or post-operative month 6 was 6.0±20.03 or −4.5±15.13 µmol/l, respectively. The stone-free rate was 100% at 3 days and at 6 months. Mild post-operative complications (Grade I or II) occurred in 6 patients, including temporary and constant elevated body temperature (>38.5°C). No severe complications, including urine leakage, sepsis, residual stones requiring auxiliary procedures, were noted and there were no circumstances requiring further surgical intervention in any of the patients. In conclusion, RLP with prolonged renal posterior lower segment incision is an effective and safe procedure for patients with staghorn renal stones and concurrent UTI, and its feasible application as a single-session monotherapy is particularly convenient considering the financial and medical situation, as well as the patients' preference.

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Early Drastic Decrease in White Blood Count Can Predict Uroseptic Shock Induced by Upper Urinary Tract Endoscopic Lithotripsy: A Translational Study

Cited by 20 publications

References 21 publications

The prognostic performance of Sepsis‑3 and SIRS criteria for patients with urolithiasis‑associated sepsis transferred to ICU following surgical interventions

The prognostic performance of Sepsis‑3 and SIRS criteria for patients with urolithiasis‑associated sepsis transferred to ICU following surgical interventions

This Month in Investigative Urology

Management of unilateral staghorn renal stones with concurrent urinary tract infections by retroperitoneal laparoscopic pyelolithotomy with prolonged renal posterior lower segment incision

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