Risk Factors for Progression to Severe Sepsis or Septic Shock in Patients with Urolith Induced Obstructive Urosepsis

Abstract

Introduction: To analyze the risk factors for the progression to severe sepsis,or septic shock,in pre-hospital patients with urolith Induced obstructive urosepsis, so as to facilitate the early identification of high-risk patients.Materials and Methods: Datas were retrospectively reviewed from 160 patients of urolith induced obstructive urosepsis between December 2013 and December 2019. There were 49 patients complicated by severe sepsis (severe sepsis group), 12 patients with septic shock (septic shock group), and 99 patients without progression to severe sepsis or septic shock (sepsis group). The data covered age, gender, BMI , time interval from ED to admission, WBC count, NLR, HGB, etc. Datas were analyzed by univariate analyses and multivariate logistic regression analysis.Results: Univariate analysis showed that the differences of age, the time interval from ED to admission, history of diabetes mellitus, history of CKI, NLR, HGB, platelet count, TBil, SCr, ALB, PT, APTT, INR, PCT, and positive rate of pathogens in blood culture were statistically significant (P < 0.05). Multivariate logistic regression analysis showed that age, SCr, and history of CKI were independent risk factors for progression to severe sepsis, or septic shock (P < 0.05).Conclusions: Aged ≥ 65 years, SCr ≥ 248 mol/L, and history of CKI were independent risk factors for progression to severe sepsis, or septic shock, in patients with urolith induced obstructive urosepsis. The key to prevent urosepsis from progression is to improve our understanding of disease dynamics, control the risk factors, and intervene the pre-hospital patients with multidisciplinary modalities as early as possible.