Gender-Based Predictors of Sepsis in Patients Undergoing Urinary Decompression for Obstructive Uropathy

Area of Science:

• Urology
• Infectious Diseases
• Gender Medicine

Background:

• Female patients exhibit increased susceptibility to stone-related infectious complications and urosepsis.
• Existing research has not fully explored gender-specific outcomes in obstructive uropathy.
• Understanding gender-based sepsis predictors is vital for effective patient management.

Purpose of the Study:

• To investigate gender-related predictors of sepsis in patients with obstructive uropathy due to ureteral stones.
• To identify differences in sepsis development between male and female patients.
• To inform gender-specific management strategies for obstructive uropathy.

Main Methods:

• Retrospective analysis of 291 patients with obstructive uropathy and ureteral stones.
• Data included clinical, laboratory, and radiological findings, and Charlson Comorbidity Index.
• Sepsis defined by Sequential Organ Failure Assessment (SOFA) score increase and positive cultures; logistic regression used for analysis.

Main Results:

• Sepsis predictors in males: older age, larger stones, elevated white blood cells, and C-reactive protein (CRP).
• Sepsis predictors in females: older age, higher Charlson Index, creatinine, and CRP.
• Females developed sepsis with smaller stones and lower CRP/creatinine levels compared to males; age and CRP were key predictors, with lower thresholds in females.

Conclusions:

• Female patients with obstructive uropathy have a higher sepsis risk than males.
• Gender-specific clinical and laboratory predictors for sepsis exist in obstructive uropathy.
• Tailored, gender-based management strategies are essential for patients with obstructive uropathy, considering lower sepsis thresholds in females.