MP10-18 SEPTIC SHOCK FOLLOWING SURGICAL DECOMPRESSION OF OBSTRUCTING URETERAL STONES: A PROSPECTIVE ANALYSIS

Abstract

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Kidney & Bladder I1 Apr 2018MP10-18 SEPTIC SHOCK FOLLOWING SURGICAL DECOMPRESSION OF OBSTRUCTING URETERAL STONES: A PROSPECTIVE ANALYSIS Paulo Moscardi, Victor Srougi, Giovanni Marchini, Ricardo Haidar, Fabio Torricelli, Miguel Srougi, William Nahas, and Eduardo Mazzucchi Paulo MoscardiPaulo Moscardi More articles by this author , Victor SrougiVictor Srougi More articles by this author , Giovanni MarchiniGiovanni Marchini More articles by this author , Ricardo HaidarRicardo Haidar More articles by this author , Fabio TorricelliFabio Torricelli More articles by this author , Miguel SrougiMiguel Srougi More articles by this author , William NahasWilliam Nahas More articles by this author , and Eduardo MazzucchiEduardo Mazzucchi More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.364AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To investigate risk factors for septic shock and death in patients with obstructive pyelonephritis due to ureteral stone, who underwent urinary tract decompression. METHODS We prospectively enrolled patients who presented at the emergency room of our institution with clinical signs of pyelonephritis, systemic inflammatory reaction syndrome (SIRS) and obstructive ureteral stone confirmed by computed tomography. Forty patients that underwent urinary tract decompression were included. Demographical, medical and laboratorial characteristics were recorded; antibiotics regimen and time from presentation to decompression were compared between patients with septic complications and patients with uneventful outcomes. RESULTS Septic shock and death occurred in 6 (15%) and 2 (5%) patients, respectively. Gender, age and co-morbidities were not associated with septic complications. Urinary culture was negative in 40% of the cohort and the most prevalent pathogen was Escherichia coli (Table 1). Administration of antibiotics other than cephalosporines was associated with septic shock (p=0.02). There was no difference between groups regarding the time of antibiotics use (p = 0.63) and time from presentation to urinary tract decompression (4.0±6.9 vs. 1.4±1.8; p=0.07; Table 2). Preoperative leucocyte count receiver operator curve for intra-operative and post-operative septic shock revealed AUC = 0.879 (p = 0.014) and AUC = 0.788 (p = 0.027), respectively (Figure 1A,B). CONCLUSIONS Time of antibiotics use and time from presentation to urinary tract decompression were not determinant to preclude patients of septic shock. Patients with elevated serum leukocytes are at substantial risk of septic shock and should undergo prompt surgical intervention. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e124 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Paulo Moscardi More articles by this author Victor Srougi More articles by this author Giovanni Marchini More articles by this author Ricardo Haidar More articles by this author Fabio Torricelli More articles by this author Miguel Srougi More articles by this author William Nahas More articles by this author Eduardo Mazzucchi More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...