Obstructive Urosepsis: Is It Possible to Personalize the Ureteral Endoscopic Treatment?
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View abstract on PubMed
Summary
This summary is machine-generated.Urinary tract infections with obstruction can be serious. This study identified key factors like platelet count and decompression time to guide treatment and improve outcomes for septic patients.
Area Of Science
- Urology
- Critical Care Medicine
- Nephrology
Background
- Urinary tract infections (UTIs) combined with ureteral obstruction present a significant mortality risk.
- While historically contraindicated, lithotripsy may be safe in select UTI cases with obstruction.
- Lack of established criteria hinders definitive treatment decisions for these patients.
Purpose Of The Study
- To identify prognostic factors for poor outcomes in patients with UTIs and ureteral obstruction.
- To determine criteria for selecting patients suitable for definitive treatment.
Main Methods
- An observational cohort study of 229 septic patients, defined by Sequential Organ Failure Assessment (SOFA) scores.
- Univariate analysis compared prognostic factors based on Δ-SOFA scores (change from admission to day 3).
- Neutrophil, lymphocyte, and platelet combinations were analyzed; time to decompression was recorded.
Main Results
- A Δ-SOFA score ≥2 was associated with longer time to urinary tract decompression (p=0.04).
- Thrombocytopenia and low platelet-to-lymphocyte ratio correlated with higher Δ-SOFA scores.
- Lower platelet counts (<105,056) and longer decompression times (>4.72 hours) predicted poorer prognosis.
Conclusions
- Accessible biomarkers, such as platelet count, can personalize treatment strategies.
- Early surgical decompression is linked to better outcomes in patients with UTIs and obstruction.
- Definitive treatment, including lithotripsy, can be safely performed in carefully selected patients.
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