MP46-14 WOMEN WITH HISTORY OF URINARY TRACT INFECTION HAVE A HIGHER RISK OF SEPSIS OR ACUTE PYELONEPHRITIS DUE TO OBSTRUCTIVE UROLITHIASIS: A 15-YEAR COHORT STUDY

Abstract

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Kidney & Bladder I (MP46)1 Apr 2020MP46-14 WOMEN WITH HISTORY OF URINARY TRACT INFECTION HAVE A HIGHER RISK OF SEPSIS OR ACUTE PYELONEPHRITIS DUE TO OBSTRUCTIVE UROLITHIASIS: A 15-YEAR COHORT STUDY Koo Yoo*, Kyle Spradling, Phil Song, Jin Oh, Sang Kim, Wuran Wei, Wansuk Kim, Sinyeong Lee, Jianlin Huang, Hyuk Cho, Shufeng Li, and Benjamin Chung Koo Yoo*Koo Yoo* More articles by this author , Kyle SpradlingKyle Spradling More articles by this author , Phil SongPhil Song More articles by this author , Jin OhJin Oh More articles by this author , Sang KimSang Kim More articles by this author , Wuran WeiWuran Wei More articles by this author , Wansuk KimWansuk Kim More articles by this author , Sinyeong LeeSinyeong Lee More articles by this author , Jianlin HuangJianlin Huang More articles by this author , Hyuk ChoHyuk Cho More articles by this author , Shufeng LiShufeng Li More articles by this author , and Benjamin ChungBenjamin Chung More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000901.014AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Sepsis or acute pyelonephritis associated with ureteral calculi is associated with significant morbidity and mortality. Identification of risk factors associated with the development of sepsis or pyelonephritis in patients with ureteral stones may lead to earlier treatment, lower mortality, and decreased overall health care costs. Herein, we aim to analyze characteristics of patients with ureteral calculi to identify risk factors for the development of sepsis or acute pyelonephritis. METHODS: Using the Optum® de-identified Clinformatics© Datamart we identified adult patients with a diagnosis of sepsis or acute pyelonephritis who underwent any procedural treatment for ureteral calculus in the United States between January 2003 to December 2017 by standardized ICD-9, ICD-10, and CPT code criteria. We abstracted patient demographic characteristics, predictive risk factors for sepsis, and cost data and performed an age-matched multivariate analysis to assess for significance. RESULTS: A total of 467,502 patients with ureteral calculi were identified during the study period. Of these, 25,747 (5.5%) were also diagnosed with sepsis or acute pyelonephritis. A total of 108,993 (23.3%) patients underwent surgical decompression for treatment of ureteral calculi including 11,103 (2.4%) patients with ureteral calculi and sepsis or acute pyelonephritis. Age-matched multivariate analysis revealed that history of urinary tract infection (OR 11.21, 95% CI 10.58-11.88, p<0.001) and female gender (OR 2.74, 95% CI 2.63-2.85, p<0.001) were associated with higher risk of sepsis or acute pyelonephritis (Table 1). Conversely, history of prior urinary stone (OR 0.89, 95% CI 0.86-0.93, p <0.0001) was associated with decreased risk of sepsis or acute pyelonephritis. CONCLUSIONS: History of urinary tract infection and female gender are risk factors for sepsis or acute pyelonephritis in patients with ureteral calculi. Female patients with ureteral stones and a history of urinary tract infections should be advised to undergo active treatment to reduce the incidence of life-threatening infections. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e678-e679 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Koo Yoo* More articles by this author Kyle Spradling More articles by this author Phil Song More articles by this author Jin Oh More articles by this author Sang Kim More articles by this author Wuran Wei More articles by this author Wansuk Kim More articles by this author Sinyeong Lee More articles by this author Jianlin Huang More articles by this author Hyuk Cho More articles by this author Shufeng Li More articles by this author Benjamin Chung More articles by this author Expand All Advertisement PDF downloadLoading ...