RISK FACTORS FOR SEPSIS FOLLOWING PERCUTANEOUS NEPHROLITHOTOMY IN THE UNITED KINGDOM

You have accessJournal of UrologyStone Disease: Surgical Therapy IV (PD42)1 Apr 2019PD42-07 RISK FACTORS FOR SEPSIS FOLLOWING PERCUTANEOUS NEPHROLITHOTOMY IN THE UNITED KINGDOM Stuart Irving*, William Finch, Daron Smith, Sarah Fowler, John Withington, and Oliver Wiseman Stuart Irving*Stuart Irving* More articles by this author , William FinchWilliam Finch More articles by this author , Daron SmithDaron Smith More articles by this author , Sarah FowlerSarah Fowler More articles by this author , John WithingtonJohn Withington More articles by this author , and Oliver WisemanOliver Wiseman More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000556563.62341.2eAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Percutaneous nephrolithotomy (PCNL) is routinely utilized in the management of large renal stones and staghorn calculi. PCNL is more efficacious when compared to other treatment modalities but carries an increased risk of morbidity. Sepsis is a known complication of PCNL with Significant associated morbidity. We sought to describe procedural and patient risk factors for blood transfusion using a national prospective data registry. METHODS: Surgeon reported data submitted to the British Association of Urological Surgeons PCNL data registry between 2011 and 2017 was analyzed for reported rates of sepsis. We assessed risk factors for sepsis, including sex, age, BMI, comorbidity, previous infections and their management, pre-existing tubes, pre op work up, induction antibiotics, stone complexity defined by Guys Stone Score (I-II versus III-IV) and patient position (prone versus supine). RESULTS: Of the 11673 PCNL procedures reported sepsis was seen in 2.5%. Significant differences were seen with higher reported rates of sepsis in female patients, the over 70's, patients with significant comorbidity, a previous history of urinary tract infections, pure or mixed growth on pre-operative MSU and more complex stone scores. There was no difference in the post-operative sepsis rates seen in obese patients, prophylactic induction antibiotic use, operative patient position, or existence of a pre-existing catheter or nephrostomy tube. CONCLUSIONS: Higher risk of post-operative sepsis can be identified in older female patients, patients with a prior history of urinary tract infections, a pre-operative MSU showing a pure growth or the presence of mixed growth. Failure to use induction antibiotics, indwelling catheters or nephrostomy tubes or patient position for surgery did not in our series increase the risk of post-operative sepsis. Source of Funding: None Norwich, United Kingdom; London, United Kingdom; Cambridge, United Kingdom© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e752-e752 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Stuart Irving* More articles by this author William Finch More articles by this author Daron Smith More articles by this author Sarah Fowler More articles by this author John Withington More articles by this author Oliver Wiseman More articles by this author Expand All Advertisement PDF downloadLoading ...