Clinical characteristics of postoperative febrile urinary tract infections after ureteroscopic lithotripsy in diabetics: How to predict?


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Kazan H. Ö. , Çakıcı M. Ç. , Efiloğlu Ö., Çiçek M., Yıldırım A. , Atış R. G.

EULIS19: 5th Meeting of the EAU Section of Urolithiasis, Milan, İtalya, 2 - 04 Ekim 2019, cilt.18, no.7, ss.2923-2924

  • Cilt numarası: 18
  • Doi Numarası: 10.1016/s1569-9056(19)33089-1
  • Basıldığı Şehir: Milan
  • Basıldığı Ülke: İtalya
  • Sayfa Sayıları: ss.2923-2924

Özet

Introduction & Objectives: There are limited clinical studies investigating characteristics and risk factors for postoperative UTI. There are some reports, defining diabetes as a risk factor for postoperative UTI, moreover it must be defined which factors have an impact on postoperative UTI in diabetics. With this report we aimed to define those factors.

Materials & Methods: Between January 2017 and April 2019, 546 patients who underwent URS for the management of ureteral and/or renal stones were included in this retrospective study.First diabetic patients with and without postoperative UTI was defined and a matched-pair analysis was done to compare the incidence of postoperative UTI between 45 diabetic patients and a matched 44 non-diabetic patients. Age, gender, body mass index (BMI), stones size, Hounsfield Unit (HU), operating time, UTI history were included for matching.Thereafter we especially focused on the different characteristics of diabetic patients with and without postoperative UTI.

Results: Overall incidence of postoperative febrile UTI was 8.1% (44/546). In diabetic patients incidence rate was 29% (13/45). After matched-pair analysis within the group of non-diabetics, incidence was 11% (5/44) which was statistically significant (p=0.04) (Table-1). Patients characteristics of diabetic patients were compared between with and without postoperative UTI. UTI history was the only statistically significant difference between groups (76.9% vs 15.6%, p=0.000) (Table-2). Diabetic patients who presented with postoperative UTI had higher HbA1c levels compared with non-UTI group (8.46 vs 6.57, p=0.013). With postoperative UTI group, preoperative ureteral stents were more often (54% vs 15.6%, p=0.009) (Table-3). In multivariate analysis HbA1c level and UTI history were the independent risk factors for developing postoperative UTI in diabetic patients (Table-4). In ROC analysis HbA1c levels’ area under curve was 0.806 and statistically significant (p=0.003). With the best prediction level HbA1c cutoff 6.9 afforded 75% sensitivity and 67% specificity for detecting postoperative UTI in diabbetics (Graph-1).