Risk factors for urinary septic shock following ureteroscopy for stone disease

Abstract

Objective:

We aimed to identify risk factors associated with urinary septic shock following ureteroscopy.

Methods:

A retrospective review was conducted on patients who underwent ureteroscopy between 2010 and 2021. Data collected included demographics and preoperative variables. Septic shock was defined as the need for vasopressors for sepsis. A comparison was made between patients who developed septic shock and a randomly selected control group (N = 115). Multivariate logistic regression was used to identify independent risk factors.

Results:

Of 5000 ureteroscopy procedures, 20 cases of septic shock were identified. These patients were older, had a higher median body mass index, more hypertension, higher preoperative urinary drainage, longer drainage duration and positive preoperative urine cultures. On multivariate analysis, age over 55 years, body mass index above 26 and positive preoperative urine culture were significant predictors of septic shock.

Conclusion:

Consistent with findings reported in previous studies, older age, higher body mass index and positive preoperative urine cultures are key risk factors for postureteroscopy septic shock. Enhanced safety measures are essential for high-risk patients.