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A quick stone component analysis matters in postoperative fever: a propensity score matching study of 1493 retrograde intrarenal surgery

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World Journal of Urology Aims and scope Submit manuscript

Abstract

Objective

To evaluate the role of stone components in postoperative fever following RIRS, and to investigate the role of quick stone component analysis during RIRS procedure.

Patients and methods

1493 patients with RIRS were retrospectively reviewed. Propensity score matching (PSM) analysis was performed as infection stones (IS) vs. calcium-containing stones (CS) and IS vs. other compositions (OS). Independent risk factors of postoperative fever were identified by logistic analysis and nomogram was constructed.

Results

A total of 73 patients suffered postoperative fever (4.9%), 8 patients with sepsis (0.5%), 4 patients with septic shock (0.3%). In IS vs. CS, the incidence of positive urine test (28.4% vs. 14.7%, p = 0.001), residual stone (48.2% vs. 37.6%, p = 0.04), and postoperative fever (9.1% vs. 2.0%, p = 0.004) was significantly higher in IS. In IS vs. OS, IS had a higher incidence of positive urine test (30.9% vs. 9.3%, p < 0.001) and residual stone (47.4% vs. 18.6%, p < 0.001), while there was no significant difference in postoperative fever (10.3% vs. 4.1%, p = 0.17). Multivariate regression analysis revealed that gender (OR 1.82, CI 1.09–3.07, p < 0.001), stone components (OR 0.6, CI 0.37–0.97, p = 0.038), urine test (OR 3.72, CI 2.23–6.20, p < 0.001), and neutrophil ratio > 75% (OR 5.17, CI 3.03–9.16, p < 0.001) were independent risk factors for postoperative fever. A nomogram with moderate discriminative ability (c-index: 0.813) was constructed to predict postoperative fever.

Conclusion

Infection stones were closely associated with postoperative fever following RIRS, as well as female gender, preoperative positive urine test, and postoperative neutrophil ratio > 75%. A quick stone component analysis would help in prevention of infectious complications. Early and longer duration of antimicrobial therapy was recommended for patients with infection stones.

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Abbreviations

RIRS:

Retrograde intrarenal surgery

PSM:

Propensity score matching

IS:

Infection stones

CS:

Calcium-containing stones

OS:

Other stones

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Funding

This study was supported by Pearl River S&T Nova Program of Guangzhou (CN) (201610010169) and Scientific Research Projects of Guangzhou Municipal Education Bureau (1201620038).

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Authors and Affiliations

  1. Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Kangda Road 1, Haizhu District, Guangzhou, 510230, China

    Linjie Peng, Zihao Xu, Junjun Wen, Wen Zhong & Guohua Zeng

  2. Guangdong Key Laboratory of Urology, Guangzhou Medical University, Guangzhou, China

    Linjie Peng, Zihao Xu, Junjun Wen, Wen Zhong & Guohua Zeng

  3. Guangzhou Institute of Urology, Guangzhou Medical University, Guangzhou, China

    Linjie Peng, Zihao Xu, Junjun Wen, Wen Zhong & Guohua Zeng

Authors
  1. Linjie Peng
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  2. Zihao Xu
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  3. Junjun Wen
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  4. Wen Zhong
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  5. Guohua Zeng
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Contributions

LP: conception and design of the study, analysis, and interpretation of data, and manuscript drafting. ZX: acquisition of data. JW: acquisition of data. WZ: analysis and interpretation of data, manuscript drafting, and critical revision. GZ: interpretation of data, critical revision, and important intellectual content.

Corresponding authors

Correspondence to Wen Zhong or Guohua Zeng.

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Conflict of interest

The authors declare that they have no competing interest.

Ethical approval

This study was approved by the Ethics Review Board of the First Affiliated Hospital of Guangzhou Medical University.

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Informed consent was obtained from all individual participants enrolled in the study.

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Peng, L., Xu, Z., Wen, J. et al. A quick stone component analysis matters in postoperative fever: a propensity score matching study of 1493 retrograde intrarenal surgery. World J Urol 39, 1277–1285 (2021). https://doi.org/10.1007/s00345-020-03268-y

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  • DOI: https://doi.org/10.1007/s00345-020-03268-y

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