Predictive factors for systemic inflammatory response syndrome following ureteroscopic lithotripys in obstructive calculus

Aim: To investigate & analyse the risk factors for the development of systemic inflammatory response syndrome following ureteroscopic lithotripsy in obstructive ureteric calculus
Methods: We prospectively collected data of 156 patients who underwent ureteroscopic lithotripsy at our Department of Urology in GoverntmentKilpauk Medical College Hospital and Government Royapettah hospital from October 2018 to March 2019. Details for the patient, the stone, and the surgical factors that potentially contributed to postoperative infection were extracted andanalyzed how the clinical factors affected the incidence of SIRS
Results: Thirty-six patients (23.07%) were postoperatively diagnosed with systemic inflammatory response syndrome; of these, 25 patients were diagnosed within 24 h after ureteroscopy. One patient required intensive care unit admission, but no death was reported. SIRS did not necessarily shift to fatal status. SIRS group required a significantly longer time to discharge after URS than the non-SIRS group indicated that post-URS SIRS imposed a physical and economic burden on the patients. Comparison between patients with post-URS SIRS and those without suggested multiple factors associated with post-URS SIRS: female gender, obstructive pyelonephritis, a positive preoperative Urine Culture result and associated diabetes mellitus& chronic kidney disease.
Conclusion: Post URS-SIRS requires longer hospital stay with prolonged antibiotic therapy and with increased economic burden. Identifying the patients with risk factors and preoperative counselling may mitigate patient concerns regarding the outcomes and helps in optimising the patient preoperatively