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- W2800902734 abstract "Background Predictive tables and scoring systems can predict stone clearance. However, there is a paucity of evidence regarding the prediction of complications during percutaneous nephrolithotomy (PCNL), particularly in children, which remains under-researched. To our knowledge, no studies have evaluated the risk factors for febrile urinary tract infection (FUTI) after pediatric PCNL. Objectives To assess the predictive factors of FUTI in prepubertal children after PCNL and determine whether any prophylactic cephalosporins are superior for decreasing the FUTI rate. Study design Data from 1157 children who underwent PCNL between 1991 and 2012 were retrieved from the multicenter database of the Turkish Pediatric Urology Society. Children >12 years of age were excluded, leaving 830 children (364 girls, 466 boys). Data were analyzed according to the presence of FUTI and compared between the FUTI and non-FUTI groups. Results Mean age was 6.46 ± 3.38 years. Twenty-nine (3.5%) children had FUTI which was confirmed by urine culture. FUTI occurred more frequently in young children (5.5%) than school-age children (2.4%). In univariate analysis, there were significant differences between the FUTI and non-FUTI groups regarding age, cephalosporin subgroup (first, second and third generation cephalosporin), side of PCNL, staghorn stones, tract size, operative time, postoperative ureteral catheter usage, perioperative complications (SATAVA), and blood transfusion. Multivariate analysis revealed that age, side of PCNL, staghorn stones, tract size, operative time, and blood transfusion were independent predictors of FUTI. Discussion The smaller tract size could cause FUTI with poor fluid drainage that may lead to elevate renal pelvic pressure and trigger bacteremia-causing pyelovenous backflow. Filling the calyx and renal pelvis by a staghorn stone and the resulting obstruction of fluid drainage may elevate intrarenal pelvis pressure. Longer operative time is likely to increase renal pelvic pressure over longer periods, which may account for FUTI after pediatric PCNL. Conclusions TablePredictive factors for FUTI. Multivariate Analysis p-value OR 95% Cl Age categories School-aged (ref) Young children 0.025 2.760 1.138–6.696 Side Left (ref) Right 0.004 4.374 1609−11,890 Staghorn stone None (ref) Yes 0.006 3.902 1.488–10.231 Tract size >20 Fr (ref) ≤20 Fr 0.011 3.148 1.307–7.580 Operative time 0.043 1.008 1.001–1.016 Blood transfusion None (ref) Yes 0.011 5.898 1.509–23.050 Open table in a new tab" @default.
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- W2800902734 date "2018-10-01" @default.
- W2800902734 modified "2023-10-18" @default.
- W2800902734 title "Factors predicting postoperative febrile urinary tract infection following percutaneous nephrolithotomy in prepubertal children" @default.
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- W2800902734 doi "https://doi.org/10.1016/j.jpurol.2018.04.010" @default.
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