PRE-PCNL INFECTION AND ITS EFFECT ON POST-PCNL OUTCOMES

You have accessJournal of UrologyStone Disease: Surgical Therapy III (MP23)1 Apr 2019MP23-09 PRE-PCNL INFECTION AND ITS EFFECT ON POST-PCNL OUTCOMES Daron Smith*, Stuart Irving, Sarah Fowler, John Withington, Ben Turney, Oliver Wiseman, and Will Finch Daron Smith*Daron Smith* More articles by this author , Stuart IrvingStuart Irving More articles by this author , Sarah FowlerSarah Fowler More articles by this author , John WithingtonJohn Withington More articles by this author , Ben TurneyBen Turney More articles by this author , Oliver WisemanOliver Wiseman More articles by this author , and Will FinchWill Finch More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000555615.97678.2aAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Details regarding infections treated before undergoing PCNL were added to the BAUS PCNL database in 2014. We analysed these data to assess the implications that pre-operative infection would have on the outcome of PCNL, especially for post-operative complications particularly regarding sepsis. METHODS: Data from the National UK PCNL database recorded between 2014-16 for patients with pre-operative treated infections were categorised into four groups: •patients who had received oral antibiotics •patients admitted for iv antibiotics •patients who required emergency drainage (either by JJ stent or nephrostomy) •patients who required an ITU admission for sepsis Chi squared analysis was performed between patients with and without prior infections RESULTS: 2630 patients were analysed. 1379 (52.4%) had no pre-PCNL infection (“Controls”). 1251 patients (47.6%) had prior treatment for infection, of whom 30.7% received at least one course of oral antibiotics, 6.9% required at least one admission for iv antibiotics, 8.3% required drainage before definitive surgery and 1.7% required an ITU admission for sepsis. Details regarding the relative likelihood of case abandonment, transfusion, Intra- and post-operative complications including fever and sepsis and Stone clearance results are shown in table 1. CONCLUSIONS: Patients who require treatment of infection prior to PCNL have an INCREASED risk of post-op complications, especially of fever and sepsis, with the highest risk in patients who have had a previous ITU admission for Sepsis. Interestingly, post-operative stone clearance rates were DECREASED in patients with prior infection. These findings are useful for pre-operative counselling, postoperative vigilance and the interpretation of PCNL outcomes in the context of case complexity. Source of Funding: None London, United Kingdom; Norwich, United Kingdom; london, United Kingdom; London, United Kingdom; Oxford, United Kingdom; Cambridge, United Kingdom; Norwich, United Kingdom© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e328-e329 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Daron Smith* More articles by this author Stuart Irving More articles by this author Sarah Fowler More articles by this author John Withington More articles by this author Ben Turney More articles by this author Oliver Wiseman More articles by this author Will Finch More articles by this author Expand All Advertisement PDF downloadLoading ...