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Can we identify the risk factors for SIRS/sepsis after percutaneous nephrolithotomy? A meta‑analysis and literature review

  • Authors:
    • Dragoş Puia
    • Ştefan Gheorghincă
    • George Daniel Radavoi
    • Viorel Jinga
    • Cătălin Pricop

  • View Affiliations

  • Published online on: January 25, 2023     https://doi.org/10.3892/etm.2023.11809
  • Article Number: 110

  • Copyright: © Puia et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

With the increase in percutaneous interventions such as percutaneous nephrolithotomy (PCNL) for renal lithiasis, infectious complications are becoming more frequent. The present study performed a systematic Medline and Embase databases search, using the following words: ‘PCNL’ [MeSH Terms] AND [‘sepsis’ (All Fields) OR ‘PCNL’ (All Fields)] AND [‘septic shock’ (All Fields)] AND [‘urosepsis’ (MeSH Terms) OR ‘Systemic inflammatory response syndrome (SIRS)’ (All Fields)]. Because of the technological advances in endourology, articles published between 2012 and 2022 were searched. Of the 1,403 results of the search, only 18 articles, representing 7,507 patients in which PCNL was performed, met the criteria to be included in the analysis. All authors applied antibiotic prophylaxis to all patients and, in some cases, the infection was treated preoperatively in those with positive urine cultures. According to the analysis of the present study, the operative time has been significantly longer in patients who developed SIRS/sepsis post‑operatively (P=0.0001) with the highest heterogeneity (I2=91%) compared with other factors. Patients with a positive preoperative urine culture had a significantly higher risk of developing SIRS/sepsis following PCNL (P=0.00001), OD=2.92 (1.82, 4.68) and there was also a high degree of heterogeneity (I2=80%). Performing a multi‑tract PCNL also increased the incidence of postoperative SIRS/sepsis (P=0.00001), OD=2.64 (1.78, 3.93) and the heterogeneity was a little smaller (I2=67%). Diabetes mellitus (P=0.004), OD=1.50 (1.14, 1.98), I2=27% and preoperative pyuria (P=0.002), OD=1.75 (1.23, 2.49), I2=20%, were other factors that significantly influenced postoperative evolution. A total of two factors analyzed, body mass index and patient's age, did not influence the outcome, P=0.45, I2=58% and P=0.98, I2=63%.
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Spandidos Publications style
Puia D, Gheorghincă Ş, Radavoi GD, Jinga V and Pricop C: Can we identify the risk factors for SIRS/sepsis after percutaneous nephrolithotomy? A meta‑analysis and literature review. Exp Ther Med 25: 110, 2023
APA
Puia, D., Gheorghincă, Ş., Radavoi, G.D., Jinga, V., & Pricop, C. (2023). Can we identify the risk factors for SIRS/sepsis after percutaneous nephrolithotomy? A meta‑analysis and literature review. Experimental and Therapeutic Medicine, 25, 110. https://doi.org/10.3892/etm.2023.11809
MLA
Puia, D., Gheorghincă, Ş., Radavoi, G. D., Jinga, V., Pricop, C."Can we identify the risk factors for SIRS/sepsis after percutaneous nephrolithotomy? A meta‑analysis and literature review". Experimental and Therapeutic Medicine 25.3 (2023): 110.
Chicago
Puia, D., Gheorghincă, Ş., Radavoi, G. D., Jinga, V., Pricop, C."Can we identify the risk factors for SIRS/sepsis after percutaneous nephrolithotomy? A meta‑analysis and literature review". Experimental and Therapeutic Medicine 25, no. 3 (2023): 110. https://doi.org/10.3892/etm.2023.11809