Are We Overreporting Post-Op Sepsis? The Difference Between Reported and Verified Rates of Post-Ureteroscopy Sepsis...

Area of Science:

• Urology
• Infectious Disease

Background:

• Ureteroscopy (URS) is a common procedure for renal stones.
• Reported post-URS sepsis rates vary, often relying on billing codes without clinical verification.
• Existing data may overestimate sepsis incidence due to diagnostic coding limitations.

Purpose of the Study:

• To determine the true incidence of sepsis after URS.
• To apply the Sepsis-3 criteria for accurate sepsis diagnosis.
• To compare findings with existing literature and highlight diagnostic accuracy needs.

Main Methods:

• Retrospective review of URS procedures (2021-2022) at a tertiary care institution.
• Electronic medical record (EMR) query for URS codes and 30-day readmissions with sepsis codes.
• Clinical evaluation of identified cases using Sepsis-3 criteria (SOFA and qSOFA scores).

Main Results:

• 1316 patients underwent URS; 14 initially coded for sepsis (1.06%).
• After clinical verification, 6 patients (0.44%) met Sepsis-3 criteria for post-URS sepsis.
• The verified sepsis rate is substantially lower than initial EMR query and reported literature.

Conclusions:

• The true incidence of post-URS sepsis is low (0.44%) when assessed rigorously with Sepsis-3 criteria.
• Discrepancies underscore the importance of accurate clinical diagnosis and documentation of sepsis post-URS.
• Findings emphasize the need for improved data validation beyond billing codes in surgical outcomes research.