Emergency decompression for patients with ureteral stones and SIRS: a prospective randomized clinical study

Figures & data

Figure 1. Flow chart of the clinical study.

Table 1. Basic data of patients.

	PCN	RUSI	p Value
Patients (%)	78 (52)	72 (48)
Age (years)^a	53.76 ± 11.24	56.40 ± 10.56	.994
Sex (male/female)^b	52/26	47/25	.599
Body mass index(BMI)^c	22.45 ± 2.31	22.52 ± 1.95	.146
Associated co-morbid condition(n/N)
Diabetes mellitus^b	20/78	14/72	.365
Hypertension^b	38/78	34/72	.855
Duration of symptom (day)^a	3.28 ± 2.19	2.75 ± 2.14	.763
Stone size (mm)^c	10.15 ± 4.26	9.88 ± 4.77	.869
Stone density (HU)^c	872.26 ± 406.4	813.00 ± 354.42	.367
Grade of hydronephrosis (n/N)^b			.560
Grade 1/2	47	40
Grade 3/4	31	32
WBC (*10^9/L)^a	13.61 ± 5.69	15.10 ± 6.07	.663
Neutrophils (*10^9/L)^a	10.50 ± 5.12	11.95 ± 6.32	.073
Serum CRP (mg/L)^a	96.78 ± 74.53	108.82 ± 76.32	.887
Serum albumin^c	35.22 ± 6.68	36.95 ± 5.41	.179
PCT^a	8.79 ± 11.61	8.19 ± 11.07	.593
Serum creatinine^a	118.64 ± 86.95	151.25 ± 117.85	.271
Urine leukocyte (/ul)^a	124.02 ± 333.77	158.46 ± 404.81	.241
Urine culture^b			.880
Positive	20	16
Negative	58	56
Blood culture^b			.817
Positive	23	28
Negative	55	44

Note: PCN: percutaneous nephrostomy; RUI: retrograde ureteral intubation; WBC: white blood cells; CRP: C-reactive protein; PCT: procalcitonin.

^aMann–Whitney U test.

^bChi square test.

^cStudent’s t-test.

Table 2. Clinical data after emergency decompression.

	PCN	RUSI	p Value
Patients (%)	78 (52)	72 (48)
Post-WBC (*10^9/L)^a	6.95 ± 2.73	7.55 ± 3.11	.188
Post-Neutrophils (*10^9/L)^a	5.64 ± 3.63	6.62 ± 3.37	.236
Post-Serum CRP (mg/L)^a	59.89 ± 52.91	71.2 ± 52.73	.824
Post-PCT^a	71.2 ± 52.73	72.14 ± 2.42	.676
Post-Serum creatinine^a	85.42 ± 46.89	95.61 ± 69.46	.099
Temperature return to normal(day)^c	2.35 ± 0.58	2.51 ± 0.62	.072
Length of stay (day)^c	7.92 ± 2.49	8.37 ± 3.07	.215
Operation time (min)^c	23.55 ± 5.02	24.27 ± 4.99	.834
Definitive treatment (PCNL or URL/ESWL)^b	73/5	51/21	<.001*
VAS scores^c	4.62 ± 1.74	4.52 ± 1.54	.277

Note: *p < 0.05. ESWL: extracorporeal shock wave lithotripsy; VAS: visual analogue scale.

^aMann–Whitney U test.

^bChi square test.

^cStudent’s t-test.

Table 3. Factors of urosepsis after emergency decompression.

	Urosepsis(−)	Urosepsis (+)	p Value
Patients (%)	122 (81.3)	28 (18.7)
Age (years)^a	54.88 ± 11.04	57.00 ± 9.87	.594
Sex (male/female)^b	80/42	19/9	.818
Body mass index^c	22.64 ± 2.41	22.33 ± 1.85	.223
Associated co-morbid condition (n/N)
Diabetes mellitus^b	24/122	10/28	.067
Hypertension^b	58/122	14/28	.814
Duration of symptom (day)^c	3.12 ± 2.18	2.61 ± 2.15	.625
Stone size (mm)^c	9.18 ± 4.59	10.00 ± 2.84	.062
Stone density (HU)^a	835.18 ± 382.48	881.46 ± 385.74	.889
Grade of hydronephrosis (n/N)^b			.599
Grade ½	72/122	15/28
Grade ¾	50/122	13/28
WBC (*10^9/L)^a	13.24 ± 5.03	21.59 ± 5.03	.255
Neutrophils (*10^9/L)^a	9.73 ± 4.83	17.90 ± 5.01	.252
Serum CRP (mg/L)^a	95.93 ± 77.33	95.93 ± 77.33	.131
Serum albumin^c	34.60 ± 6.44	34.45 ± 4.41	.107
Serum creatinine^a	134.26 ± 104.67	154.61 ± 98.39	.485
PCT^a	7.15 ± 3.86	28.09 ± 12.12	.012*
Urine leukocyte (/ul)^a	130.72 ± 362.12	180.53 ± 547.35	.171
Urine culture^b			.731
Positive	28 (22.9%)	8 (28.6%)
Negative	94 (81.1%)	20 (71.4%)
Blood culture (%)^b			<.001*
Positive	32 (26.2%)	19 (67.9%)
Negative	90 (73.8%)	9 (32.1%)
Nature of drainage fluid(%)^b			<.001*
Pyogenic fluids	32 (26.2%)	20 (71.4%)
Nonpyogenic fluids	90 (73.8%)	8 (28.6%)
PCN/RUSI^b	66/56	12/16	.283

Note: *p < 0.05. PCN: percutaneous nephrostomy; RUSI: retrograde ureteral stent insertion; WBC: white blood cells; CRP: C-reactive protein; PCT: procalcitonin.

^aMann–Whitney U test.

^bChi square test.

^cStudent’s t-test.

Table 4. Pathogenic bacteria of patients.

Variables	Total	Urosepsis (−)	Urosepsis (+)	p Value
Positive blood culture^a	51 (34%)	32 (26.2%)	19 (67.8%)	<.001*
Escherichia coli^b	34 (66.7%)	20 (39.2%)	13 (25.5%)	.669
Klebsiella pneumoniae^b	8 (15.7%)	5 (9.8%)	4 (7.8%)	.685
Enterococcus faecium^b	5 (9.8%)	4 (7.8%)	1 (1.9%)	.401
Candida^b	3 (5.9%)	2 (3.9%)	1 (1.9%)	.885
Proteus spp.	1 (1.9%)	1 (1.9%)	0

^aChi-square test.

^bFisher exact test.

*p < 0.05.

Data availability statement

All data generated or analysed during this study are included in this article. Further enquiries can be directed to the corresponding author.