Predictors of Postoperative Sepsis after Percutaneous Nephrostomy for Stone-related Urinary Tract Obstruction: A Tertiary Referral Center Experience
Haseki Tip Bulteni, cilt.64, sa.2, ss.138-146, 2026 (ESCI, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 64 Sayı: 2
- Basım Tarihi: 2026
- Doi Numarası: 10.4274/haseki.galenos.2026.64936
- Dergi Adı: Haseki Tip Bulteni
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, CINAHL, EMBASE, Directory of Open Access Journals, TR DİZİN (ULAKBİM), Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
- Sayfa Sayıları: ss.138-146
- Anahtar Kelimeler: Percutaneous nephrostomy, sepsis, urinary tract obstruction, risk factors, urolithiasis
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Aim: Percutaneous nephrostomy (PN) is a well-established method for urgent decompression in stone-related urinary obstruction; however, post-procedural sepsis remains a significant concern. This study aimed to determine the incidence and risk factors for sepsis following PN in patients with stone-related urinary tract obstruction who did not have pre-existing sepsis. Methods: This retrospective observational cohort included patients who underwent PN for stone-related urinary tract obstruction. Patients were classified as non-septic (n=290) or septic (n=18) based on postoperative (post-op) sepsis. Demographic, clinical, laboratory, microbiological, and radiological parameters were analyzed. Univariate and multivariable logistic regression analyses were performed to identify independent predictors of post-op sepsis. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the discriminative performance of the prediction model. Results: Three hundred and eight patients were included; 18 (5.9%) developed post-op sepsis. Patients with post-op sepsis had significantly higher preoperative (pre-op) body temperature, white blood cell count and neutrophil count, C-reactive protein (CRP) levels, neutrophil-to-lymphocyte ratio, and systemic immune-inflammation index. Bacterial growth in nephrostomy catheter cultures and perirenal fat stranding were more frequent in the sepsis group. Multivariable analysis identified elevated body temperature, higher pre-op neutrophil count, increased pre-op CRP, and bacterial growth in nephrostomy catheter cultures as independent predictors of post-op sepsis. ROC curve analysis showed an area under the curve (AUC) of 0.925 for the prediction model, while body temperature, pre-op CRP, and neutrophil count had AUCs of 0.777, 0.750, and 0.746, respectively. Conclusion: Percutaneous nephrostomy relieves urinary tract obstruction but may also lead to serious complications such as sepsis. An increased body temperature, a high pre-op neutrophil count, a high pre-op CRP level, and bacterial growth in nephrostomy catheter cultures were all independent predictors, and the prediction model showed excellent discrimination.