Risk factors associated with systemic inflammatory response syndrome after flexible ueteroscopic lithotripsy based on enhanced recovery after surgery

Abstract

Objective: To investigate the risk factors of systemic inflammatory response syndrome (SIRS) in patients undergoing flexible ureteroscopic lithotripsy based on enhanced recovery after surgery (ERAS). Methods: The clinical data of 243 kidney stone cases who underwent flexible ureteroscopic lithotripsy based on ERAS in the First Affiliated Hospital of Wannan Medical College from January 2016 to December 2017 were analyzed retrospectively. The cases were divided into two groups according to whether they had SIRS after surgery: SIRS group (26 cases) and non-SIRS group (217 cases). The age, gender, laterality of kidney stone, history of previous kidney stone surgery, degree of hydronephrosis, multiple kidney stones, length of operation time, white blood cell count of preoperative urine routine, result of preoperative urine culture, use of preoperative antibiotics, diabetes and other chronic diseases in the groups were collected and analyzed. Results: SIRS occurred in 26 cases in this study, which accounted for 10.7% (26/243). Multivariate analysis found that, moderate and severe hydronephrosis (OR=6.711, P=0.008), stone burden ≥2 cm (OR=10.353, P<0.001), length of operation time ≥ 60 min (OR=5.583, P=0.011), white blood cell count of preoperative urine routine ≥25×10(6)/L (OR=6.195, P=0.005), positive preoperative urine culture (OR=4.216, P=0.011), diabetes and other chronic diseases (OR=4.532, P=0.006) were the independent risk factors for postoperative SIRS (P<0.05). Conclusions: The occurrence of SIRS after flexible ureteroscopic lithotripsy based on ERAS is closely correlated with hydronephrosis, stone burden, length of operation time, white blood cell count of preoperative urine routine, positive preoperative urine culture, diabetes and other chronic diseases.