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Predictors of post-percutaneous nephrolithotomy sepsis: The Northern Malaysian experience
OBJECTIVES: Percutaneous nephrolithotomy (PCNL) carries a small risk of postoperative sepsis due to the liberation of bacteria into the patients’ bloodstream during stone fragmentation. The study aims to identify the incidence of post-PCNL sepsis in our center, as well as to delineate perioperative...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8210729/ https://www.ncbi.nlm.nih.gov/pubmed/34194142 http://dx.doi.org/10.4103/UA.UA_28_20 |
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author | Teh, Khai Yeong Tham, Teck Meng |
author_facet | Teh, Khai Yeong Tham, Teck Meng |
author_sort | Teh, Khai Yeong |
collection | PubMed |
description | OBJECTIVES: Percutaneous nephrolithotomy (PCNL) carries a small risk of postoperative sepsis due to the liberation of bacteria into the patients’ bloodstream during stone fragmentation. The study aims to identify the incidence of post-PCNL sepsis in our center, as well as to delineate perioperative characteristics associated with increased rates of sepsis. MATERIALS AND METHODS: We performed a retrospective review on all PCNLs performed in our center between July 2012 and June 2017, with emphasis on preoperative urine results, intra-operative findings, and postoperative septic complications. RESULTS: Among 425 cases of PCNL performed, 16 (3.76%) developed sepsis postoperatively. Patients with positive preoperative urine cultures were almost four times as likely to develop post-PCNL sepsis compared to those with negative cultures (8.41% vs. 2.2%, P = 0.004). Among patients with positive urine leukocytes and positive urine cultures, the presence of Staghorn calculi and multiple PCNL punctures both predicted significantly higher risks of postoperative sepsis. In contrast, diabetes mellitus and preoperative stenting were not found to be associated with a greater risk of post-PCNL sepsis. CONCLUSIONS: Patients who had positive preoperative urine leukocytes and/or cultures, and either harbor Staghorn calculi or are deemed to require more than one puncture on PCNL, were at an increased risk of developing post-PCNL sepsis. Such at-risk patients should be identified preoperatively, given aggressive perioperative antibiotic treatment, and monitored closely for septic complications during the convalescence period. |
format | Online Article Text |
id | pubmed-8210729 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-82107292021-06-29 Predictors of post-percutaneous nephrolithotomy sepsis: The Northern Malaysian experience Teh, Khai Yeong Tham, Teck Meng Urol Ann Original Article OBJECTIVES: Percutaneous nephrolithotomy (PCNL) carries a small risk of postoperative sepsis due to the liberation of bacteria into the patients’ bloodstream during stone fragmentation. The study aims to identify the incidence of post-PCNL sepsis in our center, as well as to delineate perioperative characteristics associated with increased rates of sepsis. MATERIALS AND METHODS: We performed a retrospective review on all PCNLs performed in our center between July 2012 and June 2017, with emphasis on preoperative urine results, intra-operative findings, and postoperative septic complications. RESULTS: Among 425 cases of PCNL performed, 16 (3.76%) developed sepsis postoperatively. Patients with positive preoperative urine cultures were almost four times as likely to develop post-PCNL sepsis compared to those with negative cultures (8.41% vs. 2.2%, P = 0.004). Among patients with positive urine leukocytes and positive urine cultures, the presence of Staghorn calculi and multiple PCNL punctures both predicted significantly higher risks of postoperative sepsis. In contrast, diabetes mellitus and preoperative stenting were not found to be associated with a greater risk of post-PCNL sepsis. CONCLUSIONS: Patients who had positive preoperative urine leukocytes and/or cultures, and either harbor Staghorn calculi or are deemed to require more than one puncture on PCNL, were at an increased risk of developing post-PCNL sepsis. Such at-risk patients should be identified preoperatively, given aggressive perioperative antibiotic treatment, and monitored closely for septic complications during the convalescence period. Wolters Kluwer - Medknow 2021 2021-04-13 /pmc/articles/PMC8210729/ /pubmed/34194142 http://dx.doi.org/10.4103/UA.UA_28_20 Text en Copyright: © 2021 Urology Annals https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Teh, Khai Yeong Tham, Teck Meng Predictors of post-percutaneous nephrolithotomy sepsis: The Northern Malaysian experience |
title | Predictors of post-percutaneous nephrolithotomy sepsis: The Northern Malaysian experience |
title_full | Predictors of post-percutaneous nephrolithotomy sepsis: The Northern Malaysian experience |
title_fullStr | Predictors of post-percutaneous nephrolithotomy sepsis: The Northern Malaysian experience |
title_full_unstemmed | Predictors of post-percutaneous nephrolithotomy sepsis: The Northern Malaysian experience |
title_short | Predictors of post-percutaneous nephrolithotomy sepsis: The Northern Malaysian experience |
title_sort | predictors of post-percutaneous nephrolithotomy sepsis: the northern malaysian experience |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8210729/ https://www.ncbi.nlm.nih.gov/pubmed/34194142 http://dx.doi.org/10.4103/UA.UA_28_20 |
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