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Clinical outcomes after ureteroscopic lithotripsy in patients who initially presented with urosepsis: matched pair comparison with elective ureteroscopy.

Publication ,  Journal Article
Youssef, RF; Neisius, A; Goldsmith, ZG; Ghaffar, M; Tsivian, M; Shin, RH; Cabrera, F; Ferrandino, MN; Scales, CD; Preminger, GM; Lipkin, ME
Published in: J Endourol
December 2014

BACKGROUND AND PURPOSE: The outcomes of ureteroscopy (URS) after urgent decompression and antibiotics for patients who initially present with urosepsis because of obstructive urolithiasis have not been previously evaluated. The aim of this study was to compare the outcomes and complications of URS in patients with a recent history of sepsis with those without sepsis. METHODS: The study included 138 patients who underwent URS for stone removal from January 2004 to September 2011 at a university medical center. A matched-pair analysis was performed using three parameters (age, sex, and race) to compare outcomes and complications between 69 patients who had sepsis vs a matched cohort who did not have sepsis before URS. RESULTS: The study included 138 patients, 88 (64%) females and 50 (36%) males with a median age of 57.5 years (range 18-88 years). Patients with previous sepsis had similar patient characteristics and stone-free rates (81% vs 77%) compared with patients without previous sepsis (P>0.05). Patients with previous sepsis, however, had a significantly higher complications rate (20% vs 7%), longer hospital length of stay (LOS), and longer courses of postoperative antibiotics after URS (P<0.05). Sepsis developed postoperatively in two patients with diabetes (one with and one without previous sepsis), and postoperative fever developed in five patients with previous sepsis. CONCLUSIONS: URS after decompression for urolithiasis-related sepsis has similar success but higher complication rates, greater LOS, and longer course of postoperative antibiotics. This is important in counseling patients who present for definitive URS after urgent decompression for urolithiasis-related sepsis.

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Published In

J Endourol

DOI

EISSN

1557-900X

Publication Date

December 2014

Volume

28

Issue

12

Start / End Page

1439 / 1443

Location

United States

Related Subject Headings

  • Young Adult
  • Urology & Nephrology
  • Urinary Tract Infections
  • Ureteroscopy
  • Ureterolithiasis
  • Ureteral Obstruction
  • Treatment Outcome
  • Sepsis
  • Middle Aged
  • Matched-Pair Analysis
 

Citation

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Youssef, R. F., Neisius, A., Goldsmith, Z. G., Ghaffar, M., Tsivian, M., Shin, R. H., … Lipkin, M. E. (2014). Clinical outcomes after ureteroscopic lithotripsy in patients who initially presented with urosepsis: matched pair comparison with elective ureteroscopy. J Endourol, 28(12), 1439–1443. https://doi.org/10.1089/end.2014.0343
Youssef, Ramy F., Andreas Neisius, Zachariah G. Goldsmith, Momin Ghaffar, Matvey Tsivian, Richard H. Shin, Fernando Cabrera, et al. “Clinical outcomes after ureteroscopic lithotripsy in patients who initially presented with urosepsis: matched pair comparison with elective ureteroscopy.J Endourol 28, no. 12 (December 2014): 1439–43. https://doi.org/10.1089/end.2014.0343.
Youssef RF, Neisius A, Goldsmith ZG, Ghaffar M, Tsivian M, Shin RH, et al. Clinical outcomes after ureteroscopic lithotripsy in patients who initially presented with urosepsis: matched pair comparison with elective ureteroscopy. J Endourol. 2014 Dec;28(12):1439–43.
Youssef, Ramy F., et al. “Clinical outcomes after ureteroscopic lithotripsy in patients who initially presented with urosepsis: matched pair comparison with elective ureteroscopy.J Endourol, vol. 28, no. 12, Dec. 2014, pp. 1439–43. Pubmed, doi:10.1089/end.2014.0343.
Youssef RF, Neisius A, Goldsmith ZG, Ghaffar M, Tsivian M, Shin RH, Cabrera F, Ferrandino MN, Scales CD, Preminger GM, Lipkin ME. Clinical outcomes after ureteroscopic lithotripsy in patients who initially presented with urosepsis: matched pair comparison with elective ureteroscopy. J Endourol. 2014 Dec;28(12):1439–1443.
Journal cover image

Published In

J Endourol

DOI

EISSN

1557-900X

Publication Date

December 2014

Volume

28

Issue

12

Start / End Page

1439 / 1443

Location

United States

Related Subject Headings

  • Young Adult
  • Urology & Nephrology
  • Urinary Tract Infections
  • Ureteroscopy
  • Ureterolithiasis
  • Ureteral Obstruction
  • Treatment Outcome
  • Sepsis
  • Middle Aged
  • Matched-Pair Analysis