MP29-01: Predictors of Sepsis or Acute Pyelonephritis due to Obstructive Urolithiasis: A 15-Year United States Cohort Study

Saturday, September 11, 2021 8:00 PM to 10:00 PM


Authors: Koo Han Yoo, Hyuk Jin Cho, Phil Hyun Song, Jin Kyu Oh, Sang Youn Kim, Wuran Wei, Wansuk Kim, Sinyeong Lee, Jianlin Huang, Shufeng Li, Kyle Spradling, Francesco Del Giudice, Simon Conti, Benjamin Chung

Introduction: Sepsis or acute pyelonephritis (APN) caused by obstructing ureteral calculi can have serious consequences, resulting in inpatient hospitalization or intensive care unit admission. This study aimed to identify the characteristics of patients with sepsis or APN caused by ureteral calculi and to analyze risk factors in its causation.

Methods: We included patients with sepsis or APN caused by ureteral calculi who received treatment in the United States from January 2003 to December 2017 using the Optum® de-identified Clinformatics© Datamart. Demographic factors and risk factors for the receipt of sepsis or APN were subsequently analyzed for statistical significance.

Results: A total of 467,502 patients received treatment for urinary stones were analyzed and of these, 25,747 (5.50%) were diagnosed with sepsis or APN.  Age-matched multivariate analysis revealed that history of urinary tract infection (OR 11.21, 95% CI 10.58-11.88, p<0.001) and female gender (OR 2.74, 95% CI 2.63-2.85, p<0.001) were significantly related to an increased risk of sepsis or APN. Also, the presence of comorbid conditions, especially 3 or more (OR 2.95 (2.78-3.14), p<0.001) was also a significant predictor of sepsis or APN.  Conversely, a previous past medical history of urolithiasis (OR 0.89, 95% CI 0.86-0.93, p <0.0001) and cancer (OR 0.93, 95% CI 0.89-0.97, p = 0.0002) were associated with decreased risk of sepsis or APN.

Conclusions: A history of urinary tract infection, female gender, and multiple coexisting comorbid conditions are significant risk factors for sepsis or APN in patients with ureteral calculi. These patients should be strongly advised to undergo active treatment to reduce the incidence of life-threatening infections.

Source of Funding: None
Therapeutic Area