Impact of the Timing of Percutaneous Nephrostomy on the Prognosis of Obstructive Urolithiasis With Sepsis: A Retrospective Cohort Study
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Purpose: The aim of this study was to investigate the prognostic impact of time to percutaneous nephrostomy (PCN) insertion on obstructive ureteral stones with sepsis. Materials and Methods: Data were collected on patients who presented at our Emergency Department between 2017 and 2021 with obstructive uropathy due to urinary stones and underwent PCN insertion. Patients were stratified into 4 groups in accordance with the quick sepsis-related organ failure (qSOFA) score at presentation (<2 or ≥2) and time to PCN insertion (<4 hours or ≥4 hours) as follows: group 1, qSOFA < 2 and time to PCN insertion < 4 hours; group 2, qSOFA < 2 and time to PCN insertion ≥ 4 hours; group 3, qSOFA ≥ 2 and time to PCN insertion < 4 hours; group 4, qSOFA ≥ 2 and time to PCN insertion ≥ 4 hours. The prognostic impacts of the time to PCN insertion were compared between these groups Results: The total cohort consisted of 96 patients, of whom 70 were classified as either group 1 or 2 (qSOFA < 2). Overall, 37 patients had a positive urine culture. The median time to PCN insertion was 218 minutes, and the median length of stay was 14 days. The hospitalization period was significantly shorter in group 3 than in group 4 (p=0.041). Conclusions: A shorter length of stay was associated with more rapid PCN insertion in patients with obstructive uropathy and a high risk of sepsis.
Abstract
Purpose: The aim of this study was to investigate the prognostic impact of time to percutaneous nephrostomy (PCN) insertion on obstructive ureteral stones with sepsis. Materials and Methods: Data were collected on patients who presented at our Emergency Department between 2017 and 2021 with obstructive uropathy due to urinary stones and underwent PCN insertion. Patients were stratified into 4 groups in accordance with the quick sepsis-related organ failure (qSOFA) score at presentation (<2 or ≥2) and time to PCN insertion (<4 hours or ≥4 hours) as follows: group 1, qSOFA < 2 and time to PCN insertion < 4 hours; group 2, qSOFA < 2 and time to PCN insertion ≥ 4 hours; group 3, qSOFA ≥ 2 and time to PCN insertion < 4 hours; group 4, qSOFA ≥ 2 and time to PCN insertion ≥ 4 hours. The prognostic impacts of the time to PCN insertion were compared between these groups Results: The total cohort consisted of 96 patients, of whom 70 were classified as either group 1 or 2 (qSOFA < 2). Overall, 37 patients had a positive urine culture. The median time to PCN insertion was 218 minutes, and the median length of stay was 14 days. The hospitalization period was significantly shorter in group 3 than in group 4 (p=0.041). Conclusions: A shorter length of stay was associated with more rapid PCN insertion in patients with obstructive uropathy and a high risk of sepsis.
참고문헌 (26)
- Sorokin I, "Epidemiology of stone disease across the world", World J Urol, 35, pp.1301~1320 (2017)
- Liu Y, "Epidemiology of urolithiasis in Asia", Asian J Urol, 5, pp.205~214 (2018)
- Abufaraj M, "Prevalence and trends of urolithiasis among adults", Curr Opin Urol, 32, pp.425~432 (2022)
- Chewcharat A, "Trends in the prevalence of kidney stones in the United States from 2007 to 2016", Urolithiasis, 49, pp.27~39 (2021)
- Tae BS, "Eleven-year cumulative incidence and estimated lifetime prevalence of urolithiasis in Korea : a National Health Insurance Service-National Sample Cohort Based Study", J Korean Med Sci, 33, pp.e13~ (2018)
- Jung JS, "Study on the prevalence and incidence of urolithiasis in Korea over the last 10 years : an analysis of National Health Insurance Data", Investig Clin Urol, 59, pp.383~391 (2018)
- Daniels B, "Predictors of hospital admission and urological intervention in adult emergency department patients with computerized tomography confirmed ureteral stones", J Urol, 198, pp.1359~1366 (2017)
- Zul Khairul Azwadi I, "Percutaneous nephrostomy versus retrograde ureteral stenting for acute upper obstructive uropathy : a systematic review and meta-analysis", Sci Rep, 11, pp.6613~ (2021)
- Ahmad I, "Comparison between Double J(DJ)ureteral stenting and percutaneous nephrostomy(PCN)in obstructive uropathy", Pak J Med Sci, 29, pp.725~729 (2013)
- Al-Hajjaj M, "Comparison complications rate between double-J ureteral stent and percutaneous nephrostomy in obstructive uropathy due to stone disease : A randomized controlled trial", Ann Med Surg(Lond), 81, pp.104474~ (2022)
- Elbatanouny AM, "Percutaneous nephrostomy versus JJ ureteric stent as the initial drainage method in kidney stone patients presenting with acute kidney injury : a prospective randomized study", Int J Urol, 27, pp.916~921 (2020)
- Yasrab MNI, "Analysis of use of percutaneous nephrostomy and ureteral stenting in management of ureteral obstruction", Pak J Med Health Sci, 16, pp.479~481 (2022)
- Weltings S, "Lessons from literature : nephrostomy versus double j ureteral catheterization in patients with obstructive urolithiasis-which method is superior?", J Endourol, 33, pp.777~786 (2019)
- Shoshany O, "Ureteric stent versus percutaneous nephrostomy for acute ureteral obstruction-clinical outcome and quality of life : a bi-center prospective study", BMC Urol, 19, pp.79~ (2019)
- Faw C, "Impact of the timing of ureteral stent placement on outcomes in patients with obstructing ureteral calculi and presumed infection", J Endourol, 33, pp.736~740 (2019)
- Singer M, "The Third International Consensus Definitions for Sepsis and Septic Shock(Sepsis-3)", JAMA, 315, pp.801~810 (2016)
- Teasdale G, "Assessment of coma and impaired consciousness. A practical scale", Lancet, 2, pp.81~84 (1974)
- Coll DM, "Relationship of spontaneous passage of ureteral calculi to stone size and location as revealed by unenhanced helical CT", AJR Am J Roentgenol, 178, pp.101~103 (2002)
- Blackwell RH, "Early intervention during acute stone admissions : revealing"the weekend effect"in urological practice", J Urol, 196, pp.124~130 (2016)
- Borofsky MS, "Surgical decompression is associated with decreased mortality in patients with sepsis and ureteral calculi", J Urol, 189, pp.946~951 (2013)
- Kaukonen KM, "Systemic inflammatory response syndrome criteria in defining severe sepsis", N Engl J Med, 372, pp.1629~1638 (2015)
- Gunn N, "Triage of sepsis patients : SIRS or QSOFA – which is best?", Emerg Med J, 33, pp.909~910 (2016)
- Tiwari AK, "Performance of qSOFA score as a screening tool for sepsis in the Emergency Department", J Emerg Trauma Shock, 16, pp.3~7 (2023)
- Pearle MS, "Urologic diseases in America project : urolithiasis", J Urol, 173, pp.848~857 (2005)
- Canvasser NE, "The economics of stone disease", World J Urol, 35, pp.1321~1329 (2017)
- Stokes P, "Does qSOFA score predict ICU admission and outcomes in patients with obstructed infected ureteral stones?", Can J Urol, 28, pp.10841~10847 (2021)