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A quick stone component analysis matters in postoperative fever: a propensity score matching study of 1493 retrograde intrarenal surgery.

Abstract：

OBJECTIVE:To evaluate the role of stone components in postoperative fever following RIRS, and to investigate the role of quick stone component analysis during RIRS procedure. PATIENTS AND METHODS:1493 patients with RIRS were retrospectively reviewed. Propensity score matching (PSM) analysis was performed as infection stones (IS) vs. calcium-containing stones (CS) and IS vs. other compositions (OS). Independent risk factors of postoperative fever were identified by logistic analysis and nomogram was constructed. RESULTS:A total of 73 patients suffered postoperative fever (4.9%), 8 patients with sepsis (0.5%), 4 patients with septic shock (0.3%). In IS vs. CS, the incidence of positive urine test (28.4% vs. 14.7%, p = 0.001), residual stone (48.2% vs. 37.6%, p = 0.04), and postoperative fever (9.1% vs. 2.0%, p = 0.004) was significantly higher in IS. In IS vs. OS, IS had a higher incidence of positive urine test (30.9% vs. 9.3%, p < 0.001) and residual stone (47.4% vs. 18.6%, p < 0.001), while there was no significant difference in postoperative fever (10.3% vs. 4.1%, p = 0.17). Multivariate regression analysis revealed that gender (OR 1.82, CI 1.09-3.07, p < 0.001), stone components (OR 0.6, CI 0.37-0.97, p = 0.038), urine test (OR 3.72, CI 2.23-6.20, p < 0.001), and neutrophil ratio > 75% (OR 5.17, CI 3.03-9.16, p < 0.001) were independent risk factors for postoperative fever. A nomogram with moderate discriminative ability (c-index: 0.813) was constructed to predict postoperative fever. CONCLUSION:Infection stones were closely associated with postoperative fever following RIRS, as well as female gender, preoperative positive urine test, and postoperative neutrophil ratio > 75%. A quick stone component analysis would help in prevention of infectious complications. Early and longer duration of antimicrobial therapy was recommended for patients with infection stones.

journal_name

World J Urol

journal_title

World journal of urology

authors

Peng L,Xu Z,Wen J,Zhong W,Zeng G

doi

10.1007/s00345-020-03268-y

subject

Has Abstract

pub_date

2020-05-24 00:00:00

eissn

0724-4983

issn

1433-8726

pii

10.1007/s00345-020-03268-y

pub_type

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A quick stone component analysis matters in postoperative fever: a propensity score matching study of 1493 retrograde intrarenal surgery.