Use of the Quick Sequential Organ Failure Assessment Score for Prediction of Intensive Care Unit Admission Due to Septic Shock after Percutaneous Nephrolithotomy: A Multicenter Study

Yaghoubian, Arezou; Batter, Timothy; Mozafarpour, Sarah; Sacco, Dianne; Chew, Ben H.; Monga, Manoj; Krambeck, Amy E.; Sur, Roger L.; Knudsen, Bodo E.; Mikkilineni, Nina; Shah, Ojas; Stern, Karen; De, Smita; Miller, Nicole L.; Broutian, Tatevik; Sourial, Michael; Large, Tim; Scotland, Kymora B.; Lundeen, Colin; Lange, Dirk; DiPina, Thomas; Bechis, Seth K.; Eisner, Brian H.

doi:10.1097/ju.0000000000000195

Cited by 17 publications

(7 citation statements)

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“… 10 Although we observed fewer complications with both lithotripters ( Table 2 ), 40% of the ShockPulse-SE cohort had infectious or bleeding-related complications. To verify these findings, we performed qSOFA assessment of all patients as a predictor of infectious complications after PCNL 12 and found no difference in scoring between the two cohorts ( Table 2 ). Interestingly, compared with Trilogy, we did see higher rates of secondary procedures for residual stones after ShockPulse-SE lithotripsy (17.7% vs 34.7%, p = 0.005, respectively).…”

Section: Discussionmentioning

confidence: 94%

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Multi-Institutional Prospective Randomized Control Trial of Novel Intracorporeal Lithotripters: ShockPulse-SE vs Trilogy Trial

Large

Nottingham

Brinkman

et al. 2021

Journal of Endourology

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Introduction: Currently, there are multiple intracorporeal lithotripters available for use in percutaneous nephrolithotomy (PCNL). This study aimed to evaluate the efficiency of two novel lithotripters: Trilogy and ShockPulse-SE. Materials and Methods: This is a prospective multi-institutional randomized trial comparing outcomes of PCNL using two novel lithotripters between February 2019 and June 2020. The study assessed objective measures of stone clearance time, stone clearance rate, device malfunction, stone-free rates, and complications. Device assessment was provided through immediate postoperative survey by primary surgeons. Results: There were 100 standard PCNLs completed using either a Trilogy or ShockPulse-SE lithotrite. Using quantitative Stone Analysis Software to estimate stone volume, the mean stone volume was calculated at 4.18 ± 4.79 and 3.86 ± 3.43 cm 3 for the Trilogy and ShockPulse-SE groups, respectively. Stone clearance rates were found to be 1.22 ± 1.67 and 0.77 ± 0.68 cm 3 /min for Trilogy vs ShockPulse-SE ( p = 0.0542). When comparing Trilogy to ShockPulse-SE in a multivariate analysis, total operative room time (104.4 ± 48.2 minutes vs 121.1 ± 59.2 minutes p = 0.126), rates of secondary procedures (17.65% vs 40.81%, p = 0.005), and device malfunctions (1.96% vs 34.69%, p < 0.001) were less, respectively. There was no difference in final stone-free rates between devices. Conclusion: Both the Trilogy and ShockPulse-SE lithotripters are highly efficient at removing large renal stones. In this study, we noted differences between the two devices including fewer device malfunctions when Trilogy device was utilized. Clinical Trial ID number: NCT03959683

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Section: Discussionmentioning

confidence: 94%

“…The risk of postoperative infectious complications was assessed using the quick Sequential Organ Failure Assessment (qSOFA) scoring system because of a recent Endourology Disease Group Excellence (EDGE) publication demonstrating a high prediction for infection-related complications after PCNL. 12 …”

Section: Methodsmentioning

confidence: 99%

Multi-Institutional Prospective Randomized Control Trial of Novel Intracorporeal Lithotripters: ShockPulse-SE vs Trilogy Trial

Large

Nottingham

Brinkman

et al. 2021

Journal of Endourology

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“…Yaghoubian et al (page 314) retrospectively evaluated 320 patients from various centers who underwent percutaneous nephrolithotomy. 8 The specificity for postoperative sepsis was significantly higher for qSOFA vs SIRS (93.3% vs 68.4%, p <0.001) and the positive predictive value was 13% for qSOFA and 2.9% for SIRS. A positive qSOFA also significantly predicted an increase in the probability of an emergency department visit within 30 days, operative complications and transfusion.…”

Section: Septic Shock After Percutaneous Nephrolithotomymentioning

confidence: 83%

This Month in Adult Urology

Smith¹

2019

Journal of Urology

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“…Septic shock was de ned as the need for vasopressors to maintain a mean arterial blood pressure greater than 65 mmHg and a suspected urinary tract infection [15]. The observed hypotension could not have any other possible causes, for example, anesthesia-related hypotension.…”

Section: De Nition Of Urosepsis and Septic Shockmentioning

confidence: 99%

Prediction Model of Urosepsis in Patients after Percutaneous Nephrolithotomy and Pre- and Postoperative White Blood Cell Ratio to Predict Urosepsis Progresses to Septic Shock

Hao

Wang

Wei

et al. 2022

Preprint

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Background To study the predictors of urosepsis in patients after percutaneous nephrolithotomy and progression of urosepsis to septic shock, and establish the predictive models.Methods A total of 1046 patients were included in the study. Univariate and multivariate logistic regression analyses were used to screen independent risk factors for urosepsis after PCNL and urosepsis progresses to septic shock. The normogram prediction models was established according to the related independent risk factors. Areas under the receiver operating characteristic curves, calibration plots, and decision curve analysis (DCA) were used to estimate the discrimination, calibration and clinical usefulness of the prediction model, respectively.Results Urosepsis occurred in 86 patients, and 24 of these patients developed septic shock. Multivariate logistic regression analyses showed the independent risk factors for urosepsis after PCNL were diabetes, positive urine nitrite levels, staghorn calculi, HU of hydronephrosis>6.0, AGR<1.705, and hs-CRP/Alb>0.065. The pre- and postoperative WBC ratios were independent risk factors for the progression of urosepsis to septic shock. The AUC value for predicting urosepsis risk was 0.891 and that for predicting septic shock risk was 0.982. The P values of the calibration test in the urosepsis cohort and septic shock cohort were 0.946 and 0.714, respectively. DCA of the model in the urosepsis cohort and septic shock cohort showed threshold probabilities of 10–90%.ConclusionThe individualized nomogram prediction models can help improve the early identification of patients who are at higher risk of developing urosepsis after PCNL and progression of urosepsis to septic shock, to avoid further damage.

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Use of the Quick Sequential Organ Failure Assessment Score for Prediction of Intensive Care Unit Admission Due to Septic Shock after Percutaneous Nephrolithotomy: A Multicenter Study

Cited by 17 publications

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Multi-Institutional Prospective Randomized Control Trial of Novel Intracorporeal Lithotripters: ShockPulse-SE vs Trilogy Trial

Multi-Institutional Prospective Randomized Control Trial of Novel Intracorporeal Lithotripters: ShockPulse-SE vs Trilogy Trial

This Month in Adult Urology

Prediction Model of Urosepsis in Patients after Percutaneous Nephrolithotomy and Pre- and Postoperative White Blood Cell Ratio to Predict Urosepsis Progresses to Septic Shock

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