Early Changes and Predictive Value of Serum Histone H3 Concentration in Urosepsis: A Prospective Observational Study

INTRODUCTION: To assess early changes in serum histone H3 concentration in patients with urosepsis and its predictive ability for the onset of urosepsis. METHODS: A total of 80 patients who underwent percutaneous nephrolithotripsy were enrolled in the study and divided into control and urosepsis groups based on their postoperative outcomes. Serum histone H3 concentrations were detected using an enzyme-linked immunosorbent assay, blood indexes were tested by automatic blood analyzers, and vital signs data were obtained by monitors and manual measurements. These results were correlated with the incidence of postoperative urosepsis. Repeated measurements and receiver operating characteristic curves were employed to analyze early changes and the predictive value of serum histone H3 concentration in urosepsis. RESULTS: Sixteen of the 80 patients (20%) developed urosepsis after surgery. Our data showed significant intra-group differences in terms of postoperative histone H3 concentrations (P < 0.0001) and variation trends (P < 0.0001). Among analyzed blood markers, serum histone H3 concentrations 3 h postoperation [0.825 (95% confidence interval 0.718–0.931, P < 0.0001; cut-off value 256.74 ng/ml, 93.8% sensitivity, 67.2% specificity)] and 6 h post-operation [0.834 (95% CI 0.721–0.947, P < 0.0001, cut-off value 300.875 ng/ml, 68.8% sensitivity, 87.5% specificity)] displayed a higher area under the corresponding receiver operating characteristic curves, indicating that these markers had a decent predictive value for postoperative urosepsis. CONCLUSION: Our study suggests that serum histone H3 concentration is a novel predictor of postoperative urosepsis in patients undergoing percutaneous nephrolithotripsy. The findings of this study can be validated in a larger cohort. CLINICAL TRIAL REGISTRY NUMBER: ChiCTR1800016679. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12325-021-02026-9.