Department of Critical Care Medicine, Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences, 202150 Shanghai, China.
Arch Esp Urol. 2024 Jul;77(6):638-643. doi: 10.56434/j.arch.esp.urol.20247706.87.
Ureteral calculi are a common diagnosis in the field of urology worldwide, and they represent a prevalent subtype of urolithiasis. Ureteroscopic stone surgery is the cornerstone treatment, but postoperative urinary tract infection (UTI) remains a clinical concern. Our study aims to analyse specific risk factors associated with postoperative UTIs following ureteroscopic stone surgery.
We conducted a case-control study and collected clinical data from 145 patients who underwent ureteroscopic lithotripsy at our hospital from January 2021 to January 2023. Binary logistic regression analysis was used to investigate risk factors for postoperative UTI. Receiver operating characteristic curves were plotted, and area under the curve (AUC) was calculated to evaluate the predictive value of each factor.
Forty patients developed UTI after ureteroscopic stone surgery. Compared with the control group, the case group showed significant differences in stone size, history of diabetes mellitus and preoperative urine culture results ( < 0.05). Multivariable binary logistic regression analysis revealed that stone size (Odds Ratio (OR) = 1.952, = 0.010), history of diabetes mellitus (OR = 2.438, = 0.038) and preoperative urine culture (OR = 2.914, = 0.009) were independent risk factors for postoperative UTI. The AUC values of stone size, history of diabetes mellitus and preoperative urine culture were 0.680, 0.627 and 0.630, respectively. The AUC of the combined prediction was 0.756.
This study identified risk factors for postoperative UTI following ureteroscopic stone surgery and emphasised the importance of stone size, history of diabetes mellitus and preoperative urine culture in the diagnosis.
输尿管结石是全球泌尿外科领域的常见诊断，是尿路结石的一种常见亚型。输尿管镜碎石术是基石治疗，但术后尿路感染（UTI）仍然是临床关注的问题。我们的研究旨在分析与输尿管镜碎石术后 UTI 相关的特定危险因素。
我们进行了一项病例对照研究，收集了 2021 年 1 月至 2023 年 1 月在我院接受输尿管镜碎石术的 145 例患者的临床数据。采用二元逻辑回归分析探讨术后 UTI 的危险因素。绘制受试者工作特征曲线（ROC），并计算曲线下面积（AUC）评估各因素的预测价值。
40 例患者在输尿管镜碎石术后发生 UTI。与对照组相比，病例组结石大小、糖尿病史和术前尿培养结果存在显著差异（<0.05）。多变量二元逻辑回归分析显示，结石大小（优势比（OR）=1.952，=0.010）、糖尿病史（OR=2.438，=0.038）和术前尿培养（OR=2.914，=0.009）是术后 UTI 的独立危险因素。结石大小、糖尿病史和术前尿培养的 AUC 值分别为 0.680、0.627 和 0.630，联合预测的 AUC 值为 0.756。
本研究确定了输尿管镜碎石术后 UTI 的危险因素，并强调了结石大小、糖尿病史和术前尿培养在诊断中的重要性。
