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活检前白细胞计数与前列腺活检相关脓毒症之间的关联。

Association between pre-biopsy white blood cell count and prostate biopsy - related sepsis.

作者信息

Bulut Suleyman, Aktas Binhan Kagan, Gokkaya Cevdet Serkan, Akdemir Alp Ozgur, Erkmen Akif Ersoy, Karabakan Mehmet, Memis Ali

机构信息

Ankara Numune Education and Research Hospital, Department of Urology, Ankara, Turkey.

出版信息

Cent European J Urol. 2015;68(1):86-90. doi: 10.5173/ceju.2015.01.508. Epub 2015 Mar 13.

Abstract

INTRODUCTION

Despite all preventive measures and improved biopsy techniques, serious, life-threatening complications of prostate biopsy, including sepsis, still exist. In the present study, in order to identify the risk factors that may be associated with sepsis development after prostate-biopsy, we aimed to analyze retrospectively the data of our patients who underwent transrectal ultrasound-guided prostate biopsy.

MATERIAL AND METHODS

We retrospectively reviewed the data of 889 patients who underwent prostate biopsy at our clinic. We compared pre-biopsy parameters (age, prostate volume, white blood cell (WBC) count, fasting blood glucose, free and total prostate specific antigen levels) between patients who developed sepsis and those who were sepsis-free following prostate biopsy.

RESULTS

28 patients (3.1%) developed sepsis. Among the risk factors evaluated, only pre-biopsy WBC count was found to be a significant risk factor for biopsy-related sepsis. A 5.1 fold increase was detected in the risk for sepsis development, when the cut-off value of WBC was accepted as 11.165/μL, OR: 5.1 (95% CI: 2.3-11.5). The post-biopsy sepsis development rate in patients with pre-biopsy WBC count greater and less than 11.165/μL was 13.7% (n = 10) and 3% (n = 18) respectively.

CONCLUSIONS

Patients with a pre-biopsy WBC count greater than 11.165/μL should be informed of the increased risk of developing post-biopsy sepsis.

摘要

引言

尽管采取了所有预防措施并改进了活检技术,但前列腺活检的严重、危及生命的并发症,包括败血症,仍然存在。在本研究中,为了确定可能与前列腺活检后败血症发生相关的危险因素,我们旨在回顾性分析接受经直肠超声引导前列腺活检的患者数据。

材料与方法

我们回顾性分析了在我们诊所接受前列腺活检的889例患者的数据。我们比较了前列腺活检后发生败血症的患者和未发生败血症的患者的活检前参数(年龄、前列腺体积、白细胞(WBC)计数、空腹血糖、游离和总前列腺特异性抗原水平)。

结果

28例患者(3.1%)发生败血症。在评估的危险因素中,仅活检前白细胞计数被发现是活检相关败血症的显著危险因素。当白细胞的临界值被设定为11.165/μL时,败血症发生风险增加了5.1倍,OR:5.1(95%CI:2. .3-11.5)。活检前白细胞计数大于和小于11.165/μL的患者活检后败血症发生率分别为13.7%(n = 10)和3%(n = 18)。

结论

活检前白细胞计数大于11.165/μL的患者应被告知活检后发生败血症的风险增加。

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本文引用的文献

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Reducing infection rates after prostate biopsy.降低前列腺活检后的感染率。
Nat Rev Urol. 2014 Feb;11(2):80-6. doi: 10.1038/nrurol.2013.322. Epub 2014 Jan 14.
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Antibiotic prophylaxis for transrectal prostate biopsy.经直肠前列腺活检的抗生素预防
Cochrane Database Syst Rev. 2011 May 11(5):CD006576. doi: 10.1002/14651858.CD006576.pub2.

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