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Early drastic decrease in white blood count can predict uroseptic shock induced by upper urinary tract endoscopic

Haiyang Wu1, Shibin Zhu1, Shicheng Yu1

  • 1Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.

The Journal of Urology
|January 27, 2015
PubMed
Summary
This summary is machine-generated.

A drop in white blood count within two hours after upper urinary tract endoscopic lithotripsy can predict uroseptic shock. This finding aids in prompt diagnosis and treatment of this life-threatening complication.

Keywords:
kidneyleukocyte countlithotripsysepsisshock

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Area of Science:

  • Urology
  • Nephrology
  • Critical Care Medicine

Background:

  • Uroseptic shock is a severe complication following upper urinary tract endoscopic lithotripsy.
  • Early detection and intervention are crucial for patient survival.
  • Identifying reliable predictors is essential for managing this condition.

Purpose of the Study:

  • To identify a practical predictor for uroseptic shock after upper urinary tract endoscopic lithotripsy.
  • To validate findings in both an animal model and clinical data.

Main Methods:

  • A rabbit model of uroseptic shock was created by ureteral ligation and Escherichia coli injection.
  • White blood cell count and bacterial concentrations were monitored.
  • Clinical data from 48 patients experiencing uroseptic shock were retrospectively analyzed and compared.

Main Results:

  • A rabbit model was successfully established using a specific E. coli concentration and volume.
  • A decrease in white blood count within the first two hours post-procedure was observed in both rabbits and patients with uroseptic shock.
  • Receiver Operating Characteristic (ROC) curve analysis indicated a white blood count threshold of 2.85 × 10(9)/L within two hours as a predictor, with 95.9% sensitivity and 92.7% specificity.

Conclusions:

  • A significant decrease in white blood count within two hours post-procedure is a strong predictor of uroseptic shock.
  • This WBC count change offers an ideal marker for early diagnosis.
  • Monitoring white blood cell count within two hours is recommended for high-risk patients post-lithotripsy.