Postoperative Fever and Systemic Inflammatory Response Syndrome after Ureteroscopy for Stone Disease in the Geriatric Population: Risk Factors and Determinants

Journal of Urological Surgery

article

Reha Girgin¹  Engin Denizhan Demirkiran¹ 

[1] Zonguldak Bülent Ecevit University Faculty of Medicine, Department of Urology

关键词: Postoperative fever;    Systemic inflammatory response syndrome;    Ureterorenoscopy;    Geriatric;   

DOI  :  10.4274/jus.galenos.2020.3366

学科分类：社会科学、人文和艺术（综合）

来源: Galenos Yayinevi

【 摘 要 】

Objective: The purpose of this study was to determine the perioperative risk factors for postoperative fever (POF)/systemic inflammatory response syndrome (SIRS) among geriatric patients after semi-rigid ureterorenoscopy with laser lithotripsy (RURSLL). Materials and Methods: We retrospectively reviewed data of 139 procedures from 129 consecutive geriatric patients who had undergone RURSLL for stone disease in our department. Preoperative and intraoperative characteristics between patients with and without POF/SIRS were compared using univariate analyses. The significant variables on univariate analyses were included in a multivariate logistic regression analysis to evaluate the risk factors associated with POF/SIRS following RURSLL. Results: Twenty-nine (21%) patients had POF/SIRS after RURSLL. Patients were found with higher percentage of comorbidities, body mass indices, and lower estimated glomerular filtration rates. On univariate analysis, positive preoperative urine culture, stone size, operation time, and the presence of postoperative double-J (DJ) stent were found to be significant variables (p=0.004; p=0.016; p=0.01; p=0.01, respectively). On multivariate analysis, positive preoperative urine culture [odds ratio (OR): 8.36; 95% confidence interval (CI): 2.20-31.79; p=0.002) and postoperative DJ stent insertion (OR: 6.14; 95% CI: 1.16-32.57; p=0.033) were found to be the most significant dependent variables. Conclusion: We found that positive preoperative urine culture and postoperative DJ stent insertion were the most important determinants for infectious complications after RURSLL in geriatric population. So, the procedure should be kept as short as possible, and indications for postoperative DJ catheter insertion should be reduced as much as possible.

【 授权许可】

CC BY-NC-ND