Use of the Quick Sequential Organ Failure Assessment Score for Prediction of Intensive Care Unit Admission Due to Septic Shock after Percutaneous Nephrolithotomy: A Multicenter Study

Edge Research Consortium

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1 Citation (Scopus)

Abstract

PURPOSE: Recent studies have demonstrated that quick sequential organ failure assessment criteria may be more accurate than systemic inflammatory response syndrome criteria to predict postoperative sepsis. In this study we evaluated the ability of these 2 criteria to predict septic shock after percutaneous nephrolithotomy. MATERIALS AND METHODS: We performed a retrospective multicenter study in 320 patients who underwent percutaneous nephrolithotomy at a total of 8 institutions. The criteria for quick sequential organ failure assessment and systemic inflammatory response syndrome were collected 24 hours postoperatively. The study primary outcome was postoperative septic shock. Secondary outcomes included 30 and 90-day emergency department visits, and the hospital readmission rate. RESULTS: Three of the 320 patients (0.9%) met the criteria for postoperative septic shock. These 3 patients had positive criteria for quick sequential organ failure assessment and systemic inflammatory response syndrome. Of the entire cohort 23 patients (7%) met quick sequential organ failure assessment criteria and 103 (32%) met systemic inflammatory response syndrome criteria. Specificity for postoperative sepsis was significantly higher for quick sequential organ failure assessment than for systemic inflammatory response syndrome (93.3% vs 68.4%, McNemar test p <0.001). The positive predictive value was 13% for quick sequential organ failure assessment criteria and 2.9% for systemic inflammatory response syndrome criteria. On multivariate logistic regression systemic inflammatory response syndrome criteria significantly predicted an increased probability of the patient receiving a transfusion (β = 1.234, p <0.001). Positive quick sequential organ failure assessment criteria significantly predicted an increased probability of an emergency department visit within 30 days (β = 1.495, p <0.05), operative complications (β = 1.811, p <0.001) and transfusions (p <0.001). The main limitation of the study is that it was retrospective. CONCLUSIONS: Quick sequential organ failure assessment criteria were superior to systemic inflammatory response syndrome criteria to predict infectious complications after percutaneous nephrolithotomy.

Original languageEnglish (US)
Pages (from-to)314-318
Number of pages5
JournalThe Journal of urology
Volume202
Issue number2
DOIs
StatePublished - Aug 1 2019

Fingerprint

Organ Dysfunction Scores
Percutaneous Nephrostomy
Systemic Inflammatory Response Syndrome
Septic Shock
Multicenter Studies
Intensive Care Units
Hospital Emergency Service
Sepsis
Patient Readmission
Retrospective Studies
Logistic Models
Outcome Assessment (Health Care)

Keywords

  • kidney
  • multiple organ failure
  • nephrolithotomy
  • percutaneous
  • sepsis
  • systemic inflammatory response syndrome

ASJC Scopus subject areas

  • Urology

Cite this

@article{bcd529612d9a40fa8fb2fd3371cecf7a,
title = "Use of the Quick Sequential Organ Failure Assessment Score for Prediction of Intensive Care Unit Admission Due to Septic Shock after Percutaneous Nephrolithotomy: A Multicenter Study",
abstract = "PURPOSE: Recent studies have demonstrated that quick sequential organ failure assessment criteria may be more accurate than systemic inflammatory response syndrome criteria to predict postoperative sepsis. In this study we evaluated the ability of these 2 criteria to predict septic shock after percutaneous nephrolithotomy. MATERIALS AND METHODS: We performed a retrospective multicenter study in 320 patients who underwent percutaneous nephrolithotomy at a total of 8 institutions. The criteria for quick sequential organ failure assessment and systemic inflammatory response syndrome were collected 24 hours postoperatively. The study primary outcome was postoperative septic shock. Secondary outcomes included 30 and 90-day emergency department visits, and the hospital readmission rate. RESULTS: Three of the 320 patients (0.9{\%}) met the criteria for postoperative septic shock. These 3 patients had positive criteria for quick sequential organ failure assessment and systemic inflammatory response syndrome. Of the entire cohort 23 patients (7{\%}) met quick sequential organ failure assessment criteria and 103 (32{\%}) met systemic inflammatory response syndrome criteria. Specificity for postoperative sepsis was significantly higher for quick sequential organ failure assessment than for systemic inflammatory response syndrome (93.3{\%} vs 68.4{\%}, McNemar test p <0.001). The positive predictive value was 13{\%} for quick sequential organ failure assessment criteria and 2.9{\%} for systemic inflammatory response syndrome criteria. On multivariate logistic regression systemic inflammatory response syndrome criteria significantly predicted an increased probability of the patient receiving a transfusion (β = 1.234, p <0.001). Positive quick sequential organ failure assessment criteria significantly predicted an increased probability of an emergency department visit within 30 days (β = 1.495, p <0.05), operative complications (β = 1.811, p <0.001) and transfusions (p <0.001). The main limitation of the study is that it was retrospective. CONCLUSIONS: Quick sequential organ failure assessment criteria were superior to systemic inflammatory response syndrome criteria to predict infectious complications after percutaneous nephrolithotomy.",
keywords = "kidney, multiple organ failure, nephrolithotomy, percutaneous, sepsis, systemic inflammatory response syndrome",
author = "{Edge Research Consortium} and Alan Yaghoubian and Timothy Batter and Sarah Mozafarpour and Dianne Sacco and Chew, {Ben H.} and Manoj Monga and Amy Krambeck and Roger Sur and Bodo Knudsen and Nina Mikkilineni and Ojas Shah and Karen Stern and Smita De and Nicole Miller and Tatevik Broutian and Michael Sourial and Tim Large and Kymora Scotland and Colin Lundeen and Dirk Lange and Thomas DiPina and Bechis, {Seth K.} and Eisner, {Brian H.}",
year = "2019",
month = "8",
day = "1",
doi = "10.1097/JU.0000000000000195",
language = "English (US)",
volume = "202",
pages = "314--318",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "2",

}

TY - JOUR

T1 - Use of the Quick Sequential Organ Failure Assessment Score for Prediction of Intensive Care Unit Admission Due to Septic Shock after Percutaneous Nephrolithotomy

T2 - A Multicenter Study

AU - Edge Research Consortium

AU - Yaghoubian, Alan

AU - Batter, Timothy

AU - Mozafarpour, Sarah

AU - Sacco, Dianne

AU - Chew, Ben H.

AU - Monga, Manoj

AU - Krambeck, Amy

AU - Sur, Roger

AU - Knudsen, Bodo

AU - Mikkilineni, Nina

AU - Shah, Ojas

AU - Stern, Karen

AU - De, Smita

AU - Miller, Nicole

AU - Broutian, Tatevik

AU - Sourial, Michael

AU - Large, Tim

AU - Scotland, Kymora

AU - Lundeen, Colin

AU - Lange, Dirk

AU - DiPina, Thomas

AU - Bechis, Seth K.

AU - Eisner, Brian H.

PY - 2019/8/1

Y1 - 2019/8/1

N2 - PURPOSE: Recent studies have demonstrated that quick sequential organ failure assessment criteria may be more accurate than systemic inflammatory response syndrome criteria to predict postoperative sepsis. In this study we evaluated the ability of these 2 criteria to predict septic shock after percutaneous nephrolithotomy. MATERIALS AND METHODS: We performed a retrospective multicenter study in 320 patients who underwent percutaneous nephrolithotomy at a total of 8 institutions. The criteria for quick sequential organ failure assessment and systemic inflammatory response syndrome were collected 24 hours postoperatively. The study primary outcome was postoperative septic shock. Secondary outcomes included 30 and 90-day emergency department visits, and the hospital readmission rate. RESULTS: Three of the 320 patients (0.9%) met the criteria for postoperative septic shock. These 3 patients had positive criteria for quick sequential organ failure assessment and systemic inflammatory response syndrome. Of the entire cohort 23 patients (7%) met quick sequential organ failure assessment criteria and 103 (32%) met systemic inflammatory response syndrome criteria. Specificity for postoperative sepsis was significantly higher for quick sequential organ failure assessment than for systemic inflammatory response syndrome (93.3% vs 68.4%, McNemar test p <0.001). The positive predictive value was 13% for quick sequential organ failure assessment criteria and 2.9% for systemic inflammatory response syndrome criteria. On multivariate logistic regression systemic inflammatory response syndrome criteria significantly predicted an increased probability of the patient receiving a transfusion (β = 1.234, p <0.001). Positive quick sequential organ failure assessment criteria significantly predicted an increased probability of an emergency department visit within 30 days (β = 1.495, p <0.05), operative complications (β = 1.811, p <0.001) and transfusions (p <0.001). The main limitation of the study is that it was retrospective. CONCLUSIONS: Quick sequential organ failure assessment criteria were superior to systemic inflammatory response syndrome criteria to predict infectious complications after percutaneous nephrolithotomy.

AB - PURPOSE: Recent studies have demonstrated that quick sequential organ failure assessment criteria may be more accurate than systemic inflammatory response syndrome criteria to predict postoperative sepsis. In this study we evaluated the ability of these 2 criteria to predict septic shock after percutaneous nephrolithotomy. MATERIALS AND METHODS: We performed a retrospective multicenter study in 320 patients who underwent percutaneous nephrolithotomy at a total of 8 institutions. The criteria for quick sequential organ failure assessment and systemic inflammatory response syndrome were collected 24 hours postoperatively. The study primary outcome was postoperative septic shock. Secondary outcomes included 30 and 90-day emergency department visits, and the hospital readmission rate. RESULTS: Three of the 320 patients (0.9%) met the criteria for postoperative septic shock. These 3 patients had positive criteria for quick sequential organ failure assessment and systemic inflammatory response syndrome. Of the entire cohort 23 patients (7%) met quick sequential organ failure assessment criteria and 103 (32%) met systemic inflammatory response syndrome criteria. Specificity for postoperative sepsis was significantly higher for quick sequential organ failure assessment than for systemic inflammatory response syndrome (93.3% vs 68.4%, McNemar test p <0.001). The positive predictive value was 13% for quick sequential organ failure assessment criteria and 2.9% for systemic inflammatory response syndrome criteria. On multivariate logistic regression systemic inflammatory response syndrome criteria significantly predicted an increased probability of the patient receiving a transfusion (β = 1.234, p <0.001). Positive quick sequential organ failure assessment criteria significantly predicted an increased probability of an emergency department visit within 30 days (β = 1.495, p <0.05), operative complications (β = 1.811, p <0.001) and transfusions (p <0.001). The main limitation of the study is that it was retrospective. CONCLUSIONS: Quick sequential organ failure assessment criteria were superior to systemic inflammatory response syndrome criteria to predict infectious complications after percutaneous nephrolithotomy.

KW - kidney

KW - multiple organ failure

KW - nephrolithotomy

KW - percutaneous

KW - sepsis

KW - systemic inflammatory response syndrome

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U2 - 10.1097/JU.0000000000000195

DO - 10.1097/JU.0000000000000195

M3 - Article

C2 - 30829131

AN - SCOPUS:85067802815

VL - 202

SP - 314

EP - 318

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 2

ER -