Multivariate analysis of factors for failed continuous bladder irrigation in hemorrhagic cystitis patients after hematopoietic stem cell transplantation

BMC Urology

Qi Wang¹  Qing Li¹  Yiqing Du¹  Xiaowei Zhang¹  Zhan Qu¹  Wenbo Yang¹  Wenjun Bai¹  Xiaopeng Zhang¹  Luping Yu¹  Tao Xu¹ 

[1] Department of Urology, Peking University People’s Hospital, 11 South Xizhimen Street, 100044, Beijing, China;

关键词: Continuous saline bladder irrigation;    Transplant-related adverse events;    Hemorrhagic cystitis;    C-reactive protein;    Hematopoietic stem cell transplantation;    CRP;   

DOI  :  10.1186/s12894-020-00757-5

来源: Springer

【 摘 要 】

BackgroundContinuous bladder irrigation (CBI) and proper adjustment of saline irrigation speed are important to avoid CBI failure in hemorrhagic cystitis (HC) patients after allogeneic hematopoietic stem cell transplantation (HSCT). Nevertheless, too fast irrigation speed could take away the patient's much heat, contribute to blood coagulopathy, and increase the nursing workload. Evaluation of risk for CBI failure remains an unmet clinical need.MethodsThe general information, clinical characteristics, and consultation records of HC patients in 1380 patients with hematopoietic stem cell transplantation in our center from 2017 to 2019 were analyzed retrospectively. The receiver operating characteristic (ROC) curve was used to calculate the cutoff point of the continuous variable, and multivariate logistic regression was used to analyze the risk factors affecting CBI failure in HC patients.ResultsThe incidence of HC after HSCT was 23%. A total of 227 patients with HC above grade 2 were included. Univariate analysis showed that CRP, age, platelet counts, onset time after transplantation, albumin, and hemoglobin were associated with CBI failure in the short-term (P < 0.05). ROC curve and multivariate logistic regression analysis showed that CRP > 8.89 ng/ml (RR = 7.828, 95% CI 2.885–21.244), age < 14.5 years (RR = 9.940, 95% CI 3.219–30.697), and onset time of HC > 37d after transplantation (RR = 7.021, 95% CI 2.204–22.364), were independent risk factors for failure of CBI (P < 0.05).ConclusionsThe study identified CRP > 8.89 ng/ml, age < 14.5 years, and onset time of HC after HSCT > 37d are independent factors for failure of CBI, which could be combined to allow stratification of HC after HSCT patients into low-, intermediate- and high-risk subgroups of CBI failure.

【 授权许可】

CC BY