Risk Factors Of Urosepsis After Flexible Ureteroscopy With Holmium Laser Lithotripsy

Objective: To explore the risk factors of urosepsis after flexible ureteroscopy with holmium laser lithotripsy.Methods: From February 2014 to December 2016,the clinical characters of 268 patients who had underwent flexible ureteroscopy with holmium laser lithotripsy.in the Nanchong Central Hospital and Affiliated Hospital of North Sichuan Medical College were respectively collected.A total of 28 cases with urosepsis and 260 patients without urosepsis were retrospectively analyzed by case control study to explore the risk factors.The potential risk factors of urosepsis,such as age,sex,hospital stays,serum creatinine,white blood cell,urine leukocyte,stone size,preoperative ureteral JJ stent,diabetes mellitus,hydronephrosis,preoperative urine culture,previous history of extracorporeal shock wave lithotripsy(ESWL),previous history of calculus surgery,operation time,et al.Statistically significant factors after using single factor analysis were analyzed by multivariate logistic regression method.Results: In the univariate test analysis,urosepsis following flexible uroterescopic lithotripsy was correlated with gender,hospital stays,stone size,diabetes mellitus,operation time,preoperative positive urine culture,previous history of calculus surgery(P<0.05).Introduction of multifactor binary logic analysis,showed that gender(0R=2.751,95%CI: 1.125～7.607,P=0.035),diabetes mellitus(OR=6.053,95%CI: 1.712～21.406,P=0.005)and preoperative positive urine culture(OR=9.350,95%CI: 3.331～26.249,P=0.000)were the independent risk factors.Conclusion: Gender,diabetes mellitus and preoperative positive urine culture were independent risk factors of urosepsis following flexible uroterescopic lithotripsy.It is important for early diagnosis and treatment of patients with urosepsis to minitor these Patients with these high risk factors during peri-operational period.