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Updated: Aug 29, 2025
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Noninvasive and Invasive Renal Hypoxia Monitoring in a Porcine Model of Hemorrhagic Shock
Published on: October 28, 2022
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Choosing the best way for urinary decompression and developing a novel predictive model for septic shock using SOFA
Yu Xi Terence Law1, Liang Shen2, Vincent Wei Sheng Khor3,4
1Department of Urology, National University Hospital, Singapore.
Summary
Predictive factors for sepsis/septic shock post-ureteric obstruction decompression were identified. Elevated pre-intervention temperature and a Cardiovascular SOFA score of 1 independently predicted septic shock development in patients undergoing percutaneous nephrostomy or ureteral stenting.
Area of Science:
- Urology
- Nephrology
- Critical Care Medicine
Background:
- Ureteric obstruction due to calculi can lead to sepsis/septic shock.
- Percutaneous nephrostomy (PCN) and retrograde ureteral stenting (RUS) are common decompression procedures.
- Identifying predictors of sepsis/septic shock is crucial for patient management.
Purpose of the Study:
- To identify predictive factors for sepsis/septic shock post-decompression of calculi-related ureteric obstruction.
- To compare clinical outcomes and risk ratios between PCN and RUS.
- To utilize the Sequential Organ Failure Assessment (SOFA) score for risk stratification.
Main Methods:
- Retrospective collection of clinico-epidemiological data from 537 patients undergoing PCN or RUS.
- Analysis of patient demographics, procedural details, and clinical outcomes.
- Multivariate analysis to identify independent prognostic factors for septic shock.
Main Results:
- Patients undergoing PCN were older, had poorer ECOG status, and larger calculi than RUS patients.
- PCN patients experienced longer fever, elevated white cell/creatinine, and hospital stays.
- Elevated pre-intervention temperature (OR: 2.039) and Cardiovascular SOFA score of 1 (OR: 4.037) were significant predictors of septic shock.
Conclusions:
- Both PCN and RUS have similar risks of urosepsis, septic shock, and mortality.
- RUS may be preferred for patients with lower procedural risk, despite higher failure rates.
- Consider post-decompression monitoring and inotropic support for high-risk patients (elevated temperature pre-intervention, Cardiovascular SOFA score of 1).
