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Open Access 01-12-2023 | Septicemia | Review

The influencing factors of infectious complications after percutaneous nephrolithotomy: a systematic review and meta-analysis

Authors: Guiming Zhou, Yuan Zhou, Rui Chen, Daoqi Wang, Shumin Zhou, Jiao Zhong, Yuan Zhao, Chuanping Wan, Bin Yang, Jinming Xu, Erkang Geng, Guoxiong Li, Yunfeng Huang, Haoran Liu, Jianhe Liu

Published in: Urolithiasis | Issue 1/2023

Abstract

Infection is the most common complications of percutaneous nephrolithotomy (PCNL) in treating urinary calculi. However, the risk factors for developing infectious complications after surgery have not been clarified, and the predictive value of some factors is controversial. This study aimed to assess the risk factors for postoperative infectious complications of PCNL. We performed a systematic search of PubMed, Web of Science, Cochrane Library, and EMBASE to obtain studies reporting risk factors for postoperative infection complications after PCNL. In this review, demographic factors, laboratory test factors, and perioperative factors were evaluated. The odds ratio (OR) or mean difference (MD) with a 95% confidence interval (CI) was calculated to assess the risk factors. A total of 18 studies were included, with a total of 7161 study patients with a mean age of 46.4 to 55.5 years and an incidence of infectious complications after PCNL ranging from 2.4% to 40.4%. Twelve factors were identified as independent risk factors for post-PCNL infection complications (P < 0.05), female (OR = 1.60, 95% CI 1.23–2.07), positive urine culture (UC) (OR = 3.16, 95% CI 2.11–4.74), positive renal pelvis urine culture (RPUC) (OR = 5.81, 95% CI 1.75–19.32), positive stone culture (SC) (OR = 5.11, 95% CI 1.46–17.89), positive urine leukocyte (OR = 3.61, 95% CI 2.45–5.34), infected stones (OR = 7.00, 95% CI 1.27–38.55), elevated blood leukocyte (MD = 0.71, 95% CI 0.31–1.10), elevated neutrophil-to-lymphocyte ratio (NLR) (MD = 0.55, 95% CI 0.43–0.66), preoperative stenting (OR = 1.55, 95% CI 1.10–2.20), multiple puncture access (OR = 2.58, 95% CI 1.75–3.82), prolonged operative time (MD = 10 20, 95% CI 4.80–15.60), and postoperative residual stone (OR = 1.56, 95% CI 1.24–1.98). Female, UC positivity, RPUC positivity, SC positivity, urine leukocyte positivity, infected stones, elevated peripheral blood leukocytes, elevated NLR, preoperative stent implantation, multiple puncture channels, prolonged operation time, and postoperative residual stones were identified as independent risk factors for infection complications after PCNL.

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Title: The influencing factors of infectious complications after percutaneous nephrolithotomy: a systematic review and meta-analysis
Authors: Guiming Zhou
Yuan Zhou
Rui Chen
Daoqi Wang
Shumin Zhou
Jiao Zhong
Yuan Zhao
Chuanping Wan
Bin Yang
Jinming Xu
Erkang Geng
Guoxiong Li
Yunfeng Huang
Haoran Liu
Jianhe Liu
Publication date: 01-12-2023
Publisher: Springer Berlin Heidelberg
Keywords: Septicemia
Septicemia
Urinary Tract Infection
Urosepticemia
Published in: Urolithiasis / Issue 1/2023
Print ISSN: 2194-7228
Electronic ISSN: 2194-7236
DOI: https://doi.org/10.1007/s00240-022-01376-5

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The influencing factors of infectious complications after percutaneous nephrolithotomy: a systematic review and meta-analysis

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