Renal pelvis urine Gram stain as a traditional, but new marker in predicting postoperative fever and stone culture positivity in percutaneous nephrolithotomy: an observational, prospective, non-randomized cohort study

2020 ◽  
Author(s):  
Nejdet Karsiyakali ◽  
Ugur Yucetas ◽  
Aysel Karatas ◽  
Emre Karabay ◽  
Emrah Okucu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Percutaneous Nephrolithotomy ◽  
Renal Pelvis ◽  
Gram Stain ◽  
Postoperative Fever ◽  
Culture Positivity ◽  
Stone Culture

scholarly journals Neither Blood Culture Positivity nor Time to Positivity is Associated with Mortality among Patients Presenting with Severe Manifestations of Sepsis: The FABLED Cohort Study

2021 ◽  
Author(s):  
Katryn Paquette ◽  
David Sweet ◽  
Robert Stenstrom ◽  
Sarah N Stabler ◽  
Alexander Lawandi ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cohort Study ◽  
Blood Culture ◽  
Blood Cultures ◽  
Cell Counts ◽  
Culture Positivity ◽  
Time To Positivity ◽  
Blood Culture Positivity ◽  
Normal White Blood Cell ◽  
Support Fund

Abstract Background Sepsis is a leading cause of morbidity, mortality, and health care costs worldwide. Methods We conducted a multi-center, prospective cohort study evaluating the yield of blood cultures drawn before and after empiric antimicrobial administration among adults presenting to the emergency department with severe manifestations of sepsis (ClinicalTrials.gov: NCT01867905). Enrolled patients who had the requisite blood cultures drawn were followed for 90 days. We explored the independent association between blood culture positivity and its time to positivity in relation to 90-day mortality. Findings 325 participants were enrolled; 90-day mortality among the 315 subjects followed-up was 25·4% (80/315). Mortality was associated with age (mean age in those who died was 72·5 ±15·8 vs. 62·9 ±17·7 years among survivors, p<0·0001), greater Charlson Comorbidity Index (2 (IQR 1,3) vs. 1 (IQR 0,3), p=0·008), dementia (13/80 (16·2%) vs. 18/235 (7·7%), p=0·03), cancer (27/80 (33·8%) vs. 47/235 (20·0%), p=0·015), positive qSOFA score (57/80 (71·2%) vs. 129/235 (54·9%), p=0·009), and normal white blood cell counts (25/80 (31·2%) vs. 42/235 (17·9%), p=0·02). The presence of bacteremia, persistent bacteremia after antimicrobial infusion, and shorter time to blood culture positivity were not associated with mortality. Neither the source of infection nor pathogen affected mortality. Interpretation Although severe sepsis is an inflammatory condition triggered by infection, its 90-day survival is not influenced by blood culture positivity nor its time to positivity. Funding Vancouver Coastal Health; St-Paul’s Hospital Foundation Emergency Department Support Fund; the Fonds de Recherche Santé – Québec (CPY); Intramural Research Program of the NIH, Clinical Center (AL); the Maricopa Medical Foundation

scholarly journals Lithotrites and Postoperative Fever: Does Lithotrite Type Matter? Results from the Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study

2013 ◽  
Vol 91 (3) ◽  
pp. 340-344 ◽  
Author(s):  
David I. Chu ◽  
Michael E. Lipkin ◽  
Agnes J. Wang ◽  
Michael N. Ferrandino ◽  
Glenn M. Preminger ◽  
...  
Keyword(s):  
Clinical Research ◽  
Percutaneous Nephrolithotomy ◽  
Postoperative Fever ◽  
Global Study ◽  
Research Office

scholarly journals A Major Complication in Micropercutaneous Nephrolithotomy: Upper Calyceal Perforation with Extrarenal Migration of Stone Fragments due to Increased Intrarenal Pelvic Pressure

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Fatih Akbulut ◽  
Burak Ucpinar ◽  
Metin Savun ◽  
Onur Kucuktopcu ◽  
Faruk Ozgor ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Renal Pelvis ◽  
Laser System ◽  
Major Complication ◽  
Efficient Technique ◽  
Yag Laser ◽  
Stone Clearance ◽  
Micropercutaneous Nephrolithotomy ◽  
Effective Drainage ◽  
Pelvic Pressure

Micropercutaneous nephrolithotomy is a safe and efficient technique for appropriate sized stones. It is performed through a 4.85 Fr all-seeing needle and stones are fragmented into dust, without the need for tract dilatation, unlike other percutaneous nephrolithotomy types. Even though micropercutaneous nephrolithotomy has many advantages, increase in intrapelvic pressure during surgery may cause rare but serious complications. Herein we report a case of micropercutaneous nephrolithotomy in a 20-year-old woman with a 20 mm right renal pelvis stone and present an undesired outcome of this complication, upper calyceal perforation. Right lower calyceal access was performed with 4.85 Fr all-seeing needle and 2 cm renal pelvis stone was fragmented by 272 μm Holmium-Yag laser system. Upper calyceal perforation and infrahepatic accumulation of stone fragments were detected by fluoroscopy during the surgery. Postoperative imagings revealed perirenal urinoma, perirenal and infrahepatic stone fragments, and lower calyceal stone fragments inside the system. On second postoperative day, minipercutaneous nephrolithotomy and double J catheter insertion procedures were applied for effective drainage and stone clearance. Risk of calyceal perforation and urinoma formation, due to increased intrapelvic pressure during micropercutaneous nephrolithotomy, should be kept in mind.

Stone culture retrieved during percutaneous nephrolithotomy: is it clinically relevant?

Urolithiasis ◽  
2016 ◽  
Vol 44 (4) ◽  
pp. 327-332 ◽  
Author(s):  
Yasser Osman ◽  
Ahmed M. Elshal ◽  
Mohamed M. Elawdy ◽  
Helmy Omar ◽  
Asaad Gaber ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Stone Culture

scholarly journals The Evaluation of Risk Factors for Postoperative Infectious Complications after Percutaneous Nephrolithotomy

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Tian Yang ◽  
Shenghua Liu ◽  
Jimeng Hu ◽  
Lujia Wang ◽  
Haowen Jiang
Keyword(s):  
Risk Factors ◽  
Serum Albumin ◽  
Percutaneous Nephrolithotomy ◽  
Protective Factor ◽  
Clinical Information ◽  
Renal Stones ◽  
Infectious Complications ◽  
Stone Size ◽  
Postoperative Fever ◽  
Detailed Clinical Information

This study was to evaluate the risk factors of infectious complications after percutaneous nephrolithotomy (PCNL) and build a prediction tool for postoperative complications based on the risk factors. A total of 110 male (67.1%) and 54 female (32.9%) patients who underwent PCNL for renal stones between 2010 and 2014 in our institute were included. A detailed clinical information and laboratory results were obtained from patients. Systemic inflammatory response syndrome (SIRS) and postoperative fever were recorded after PCNL surgery. In all, 45 cases (27.4%) developed SIRS and fever was observed in 20 cases (12.2%). In multivariate analysis, stone size (odds ratio, OR = 1.471,p=0.009) and urine white blood cell (WBC) (OR = 1.001,p=0.007) were related to the development of SIRS. Stone size (OR = 1.644,p=0.024), urine WBC (OR = 1.001,p=0.002) and serum albumin (OR = 0.807,p=0.021) were associated with postoperative fever. We concluded that patients with larger stone size and preoperative urinary tract infection might have a higher risk of developing SIRS and fever after operation, while a high-normal level of serum albumin might be the protective factor for postoperative fever.

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