Abstract | PURPOSE: METHODS: A retrospective study of patients who underwent PCNL between April 2011 and March 2018 was performed. The data of the struvite stones and non- struvite stones groups were compared following propensity score matching. Subsequently, the struvite stones group was sub-divided for further analysis according to the Sepsis-3 definition: non- sepsis and sepsis groups. RESULTS: After matching based on age, gender, BMI, and number of access tracts, the comparative analysis showed that staghorn calculi and higher Guy's stone score were more frequently observed in non- struvite stone patients (n = 97), while a history of urolithiasis surgery (56.70%), preoperative broad-spectrum antibiotic therapy (53.61%), positive preoperative urine culture (55.67%), and sepsis (35.05%) after surgery were more common in patients (n = 97) with struvite stones (all P values < 0.05). Eighteen (18.56%) patients presented with multidrug-resistant (MDR) bacteriuria. Multivariate analysis demonstrated that the preoperative presence of MDR bacteriuria (OR = 3.203; P = 0.043) and increased serum creatinine (OR = 3.963; P = 0.010) were independent risk predictors of sepsis. The two factors were used to construct a nomogram to predict the probability of sepsis. The nomogram was well calibrated and had moderate discriminative ability (concordance index: 0.711). CONCLUSION: Our study revealed that patients with struvite stones were associated with a significantly high risk of calculi recurrence and sepsis after surgery. The presence of MDR bacteriuria preoperatively was a reliable factor to predict sepsis.
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Authors | Xiaomin Gao, Chaoyue Lu, Fei Xie, Ling Li, Min Liu, Ziyu Fang, Zeyu Wang, Shaoxiong Ming, Hao Dong, Rong Shen, Yinghao Sun, Yonghan Peng, Xiaofeng Gao |
Journal | World journal of urology
(World J Urol)
Vol. 38
Issue 1
Pg. 219-229
(Jan 2020)
ISSN: 1433-8726 [Electronic] Germany |
PMID | 30972490
(Publication Type: Comparative Study, Journal Article)
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Chemical References |
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Topics |
- Anti-Bacterial Agents
(therapeutic use)
- China
(epidemiology)
- Female
- Humans
- Incidence
- Male
- Middle Aged
- Nephrolithotomy, Percutaneous
(adverse effects)
- Retrospective Studies
- Risk Assessment
(methods)
- Risk Factors
- Sepsis
(epidemiology, etiology, prevention & control)
- Staghorn Calculi
(diagnosis, surgery)
- Surgical Wound Infection
(epidemiology, etiology, prevention & control)
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