MP14-17 MORTALITY ASSOCIATED WITH SEPSIS POST-URETEROSCOPY AMONG A US-BASED COMMERCIAL POPULATION

Abstract

You have accessJournal of UrologyCME1 May 2022MP14-17 MORTALITY ASSOCIATED WITH SEPSIS POST-URETEROSCOPY AMONG A US-BASED COMMERCIAL POPULATION Naeem Bhojani, Brian Eisner, Manoj Monga, Rutugandha Paranjpe, Benjamin Cutone, and Ben H. Chew Naeem BhojaniNaeem Bhojani More articles by this author , Brian EisnerBrian Eisner More articles by this author , Manoj MongaManoj Monga More articles by this author , Rutugandha ParanjpeRutugandha Paranjpe More articles by this author , Benjamin CutoneBenjamin Cutone More articles by this author , and Ben H. ChewBen H. Chew More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002543.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Real-world outcomes including mortality associated with sepsis post-ureteroscopy (URS) have not been previously reported. The objective of the current study was to evaluate all-cause inpatient mortality among patients who develop sepsis post-URS compared first to a non-sepsis cohort and second to a severe sepsis cohort. METHODS: Two retrospective claims analyses were conducted using IBM MarketScan commercial data. Patients aged 18+ were included if they had a URS procedure. A sepsis or severe sepsis event was defined as the first sepsis or severe sepsis event within 30-days post-URS. In the first analysis the sepsis cohort comprised of patients with sepsis or severe sepsis while in the second analysis the sepsis and severe patients were distinct. All-cause inpatient mortality was measured within 30-days of the sepsis or severe sepsis event and within 30-days of URS in the non-sepsis cohort. Descriptive analyses were conducted in the sepsis, severe sepsis and non-sepsis cohorts comparing all-cause inpatient mortality and time to all-cause inpatient death (days). Lastly, two multivariable cox regression models were conducted to evaluate the effect of sepsis and severe sepsis on all-cause inpatient mortality. RESULTS: The URS cohort comprised of 109,496 patients. The overall incidence of developing sepsis was 5.6%. Of these, 4.1% developed sepsis while 1.5% developed severe sepsis. The all-cause inpatient mortality among the severe sepsis, sepsis and non-sepsis cohort was 2.5%, 0.82%, and 0.03% respectively. The mean time to death in the sepsis cohort was significantly shorter than the non-sepsis cohort (9.6 days vs 16.7 days; p<0.001). Similarly, the mean time to death in the severe sepsis cohort was significantly shorter than the sepsis cohort (8.7 days vs 11.1 days; p<0.001). The first cox regression model determined that predictors of higher all-cause inpatient mortality after URS included sepsis (sepsis vs non-sepsis HR:17.2; 95% CI: 10.5-28.0; p<0.001) older age (55-64; p<0.024) and higher Elixhauser comorbidity index (p<0.001). Lastly, patients who developed severe sepsis (model 2) were significantly associated with higher all-cause inpatient mortality as compared to patients who developed sepsis (HR: 8.2; 95% CI: 4.24-15.83; p<0.001). CONCLUSIONS: The study findings demonstrated that both sepsis and severe sepsis post-URS are significant clinical events associated with significant morbidity and even mortality. Appropriate measures to prevent sepsis and severe sepsis post-URS are of utmost importance. Source of Funding: Boston Scientific © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e239 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Naeem Bhojani More articles by this author Brian Eisner More articles by this author Manoj Monga More articles by this author Rutugandha Paranjpe More articles by this author Benjamin Cutone More articles by this author Ben H. Chew More articles by this author Expand All Advertisement PDF DownloadLoading ...