Investig Clin Urol.  2018 Nov;59(6):371-375. 10.4111/icu.2018.59.6.371.

Are there any predictive risk factors for failure of ureteric stent in patients with obstructive urolithiasis with sepsis?

• Pandey S
• Sharma D
• Sankhwar S
• Singh M
• Garg G
• Aggarwal A
• Sharma A
• Agarwal S

• KMID: 2424291
• DOI: http://doi.org/10.4111/icu.2018.59.6.371

Abstract

PURPOSE
To compare patients with sepsis due to obstructive urolithiasis (Sep-OU) and underwent drainage by percutaneous nephrostomy (PCN) or a double-J (DJ)-ureteral stent and to identify predictive risk factors of DJ stent failure in these patients.
MATERIALS AND METHODS
We reviewed our records from January 2013 to July 2018 and identified 286 adult patients with Sep-OU out of which 36 had bilateral involvement, thus total 322 renal units were studied. Urologic residents in training carried out both ureteral stenting and PCN tube placement. Demographic data and stone characteristics were recorded along with Charlson comorbidity index. For predicting risk factors of DJ stent failure, those variables that had a p-value < 0.1 in univariate analysis were combined in a multinomial regression analysis model.
RESULTS
The patients with PCN placement were significantly older than those with DJ stent placement (p=0.001) and also had significant number of units with multiple calculi (p=0.018). PCN was also placed more frequently in those patients with a upper ureteric calculi (p < 0.05). On multinomial regression analysis multiple calculi (p=0.014; odds ratio [OR], 4.878; 95% confidence interval [CI], 1.377-17.276) and larger calculi size (p=0.040; OR, 0.974; 95% CI, 0.950-0.999) were the significant predictors of DJ stent failure.
CONCLUSIONS
In patients with sepsis from obstructive urolithiasis due to larger and multiple calculi a PCN placement might be better suited although this data requires further prospective randomized studies to be extrapolated.

Keyword

Percutaneous nephrostomy; Sepsis; Stent; Ureter; Urolithiasis

MeSH Terms

Adult
Calculi
Comorbidity
Drainage
Humans
Nephrostomy, Percutaneous
Odds Ratio
Pregnenolone Carbonitrile
Prospective Studies
Risk Factors*
Sepsis*
Stents*
Ureter*
Urolithiasis*
Pregnenolone Carbonitrile

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