Analysis Of Risk Factors Of SIRS Following Retrograde Intrarenal Surgery In The Treatment Of Urolithiasis

Objective:To investigate the risk factors of systemic inflammatory response syndrome(SIRS)after retrograde intrarenal surgery(RIRS)with holmium laser lithotripsy in patients with renal or/and proximal ureteral calculi.Methods:The clinical data of 890 patients who underwent RIRS with holmium laser lithotripsy for renal or/and proximal ureteral calculi were retrospectively analyzed from November 2013 to August 2016.The patients were divided into two groups,and the Odds ratio(OR)and the 95%confidence interval(95%CI)were calculated by univariate Logistic regression analysis and multivariate Logistic regression analysis to determine the risk factors after RIRS.Results:In 890 patients(male 584,female 306),SIRS(37/890)was found in all of the 4.2%patients.In univariate analysis,SIRS was significantly related to the use of immunosuppressive agents,a recent history of stone ralated fever,preoperative positive urine culture,preoperative WBCs in urine,and urine pus during operation(P<0.05),there was no significant correlation with gender,age,BMI,hypertension,diabetes mellitus before operation,the serum creatinine level,operation time,and stone size(P>0.05);Multivariate analysis further confirmed that SIRS was significantly associated with a recent history of stone ralated fever(P=0.014,OR=4.22,95%CI:1.341～13.331),preoperativeurine WBCs increased significantly(P<0.001,OR=5.075,95%CI:2.350～10.959),intraoperative urine pus(P<0.001,OR=8.373,95%CI:2.773～25.279).Conclusion:a recent history of stone ralated fever,preoperative WBCs in urine,intraoperative urine pus are risk factors for SIRS after RIRS,The risks should be paid for full attention,controlled and treated before operation,if necessary,surgical staging should be needed.