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Risk factors for urinary lithotripsy-associated sepsis
R Orenstein1, J E Bross, M Dahlmann
1Department of Infectious Disease, Geisinger Medical Center, Danville, PA 17822.
Infection Control and Hospital Epidemiology
|August 1, 1993
Summary
Urinary tract infections and larger stone size may increase sepsis risk after extracorporeal shock wave lithotripsy (ESWL). Preprocedure evaluation can identify high-risk patients for tailored care to prevent infectious complications.
Area of Science:
- Urology
- Infectious Disease
- Nephrology
Background:
- Urinary extracorporeal shock wave lithotripsy (ESWL) is a common procedure for kidney stones.
- Sepsis is a serious potential complication following ESWL.
Purpose of the Study:
- To identify risk factors for developing sepsis after urinary ESWL.
- To improve patient selection and management for ESWL.
Main Methods:
- Retrospective case-control study design.
- Comparison of six sepsis cases with 36 controls (two groups of 18).
- Data collected from a regional referral center.
Main Results:
- Cases with sepsis had a higher frequency and number of pre-existing urinary tract infections.
- Larger kidney stone size was associated with increased sepsis risk.
- Bacteremia and fungemia were observed in the case group.
Conclusions:
- Preprocedure evaluation is crucial for identifying patients at high risk for infectious complications after ESWL.
- High-risk patients may benefit from alternative prophylactic treatments.
- Close post-ESWL monitoring is recommended for at-risk individuals.