Predictive factors of postminimally invasive lithotripsy urosepsis and its impact on prognosis

Percutaneous nephrolithotomy (PCNL) is an important treatment for kidney stones, but post-operative urosepsis is a serious complication. This study aimed to analyze the risk predictors of post-PCNL urosepsis and evaluate its impact on patient prognosis. Clinical data of 218 patients who underwent PCNL at our hospital from January 2020 to December 2023 were retrospectively analyzed. Univariate and multivariate logistic regression analyses were used to identify independent risk factors for post-operative urosepsis. Kaplan-Meier survival analysis was used to assess the impact of urosepsis on patient prognosis. Among 218 patients, 18 (8.26%) developed post-operative urosepsis. Multivariate analysis showed that positive preoperative urine culture (OR=3.24, 95%CI: 1.86-5.63), stone burden >4cm (OR=2.78, 95%CI: 1.59-4.86), operation time >90 minutes (OR=2.15, 95%CI: 1.23-3.75), and diabetes (OR=1.92, 95%CI: 1.08-3.41) were independent risk factors for post-operative urosepsis. The urosepsis group showed significantly prolonged hospital stay (P<0.001) and increased 30-day readmission rate (P=0.003). Positive preoperative urine culture, large stone burden, extended operation time, and comorbid diabetes are important predictive factors for post-PCNL urosepsis. Post-operative urosepsis significantly affects patient prognosis. Clinicians should take active preventive measures for high-risk patients to improve surgical outcomes.