Risk factors of sepsis development after percuaneous nephrolithotomy



'''Purpose:'''  Sepsis is a life-threatening complication after percutaneous nephrolithotomy (PCNL). The aim of this study is to identify the possible predisposing factor of sepsis after PCNL.      

'''Materials and Methods:'''  Retrospective review of all patient received PCNL between January 2001 and December 2015 in our hospital. There were 1477 cases included and 19 (1.29%) of them developed sepsis after PCNL. Univariate and multivariable analyses identified risk factor associated with sepsis after PCNL.      

'''Results:'''  There was no difference in gender, age, body mass index and diabetes mellitus history in developing sepsis. There also no significant difference was noted in the mean stone size in sepsis or non-sepsis group. Comparing the operation time, no significant difference was noted between two groups. In 19 patients developed sepsis, 17 of them was admitted for renal stone (OR: 8.70; 95% CI 2.00–37.79; P = 0.004) and 2 of them for staghorn stone. There was no sepsis was noted in 313 of 1477 cases for upper ureteral stone after PCNL. Furthermore, Residual stone after PCNL was noted in 10 of 19 patients (OR: 3.36; 95% CI 1.36–8.34; P = 0.009).      

'''Conclusion:'''  The major factors of developing post PCNL sepsis are pre-operative renal stone and residual stone after PCNL. Early identification of high-risk patient after PCNL may help broad-spectrum antibiotic prescription earlier in order to control sepsis progression.