Login to Access Video or Poster Abstract: MP50-10
Sources of Funding: None.

Introduction

Ureteroscopy (URS) is the standard of care for surgical management of small upper urinary tract stones. A common and life-treating complication of URS is post-operative infection. The objective was to identify risk factors for post-operative fever (POF) and systemic inflammatory response syndrome (SIRS) after URS.

Methods

We identified 2375 URS performed for stone disease in an integrated healthcare delivery system from 2008-2014. The primary outcome was POF (temperature greater than 100.4F) or SIRS (yes/no). The study team selected preoperative and intraoperative risk factors for data collection a priori. Univariate comparisons were performed between those who had POF/SIRS and those who did not. Variables with a p value <0.1 were entered into a stepwise logistic regression model.

Results

A total of 179 out of 2375 patients had POF/SIRS (7.5%). Subjects with POF/SIRS were older, female, had higher body mass index (BMI) and Charlson comorbidity index (CCI), bilateral stones, stone size >= 1cm, renal location, pre-stenting, positive preoperative urine culture, and post-operative antibiotics. Table 1 demonstrates the univariate analysis of candidate predictors and POF/SIRS. Sex, CCI, laterality (unilateral or bilateral), stone location (renal, ureteral, or both), and type of ureteroscope comprised the final model (Table 2).

Conclusions

Female sex, higher CCI, using both flexible and semi-rigid ureteroscopes, renal stones, and bilateral stones are associated with POF/SIRS after URS. This data may be used to identify and counsel high-risk individuals for surgical planning.

Funding

None.