Presented by: Ji Eun Yu MD
Konyang University College of Medicine

Introduction

In patients with obstructing ureteral stone, immediate renal decompression using percutaneous nephrostomy (PCN) or cystoscopic double-j stent indwelling are standard of care if infection is suspected. Previous study has shown that the timing of ureteral stent placement impact on the clinical outcome of patients with obstructing ureteral stones with sepsis. Even though PCN is alternative option for renal decompression, the impact of timing of PCN on the patient outcome is not well understood.

Materials

Using a database from 2017 to 2021, we evaluated patients who visited emergency department with obstructive uropathy due to urinary stones and underwent percutaneous nephrostomy insertion. We classified patients in two groups, whom met quick sequential organ failure(qSOFA) score of lesser than two, and qSOFA score of two or more, and retrospectively investigated patients.The aim of this study is to understand how time to percutaneous nephrostomy insertion affects the prognosis, including total length of stay, need for intensive care unit.

Results

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Total 96 patients met the criteria. 70 patients had qSOFA score of lesser than two, and 26 patients had qSOFA score of two or more. Overall, 37 patients  have positive urine culture. Mean time to percutaneous nephrostomy insertion was 229 minutes, and mean length of stay was 18.11 days. There was no difference between groups in clinical values. In group of qSOFA score of lesser than two, there was no correlation between the time to procedure and length of stay, but in group of qSOFA score of two or more, hospitalization days was significantly shorter in patients of percutaneous nephrostomy before 4 hours than patients whom underwent procedure after 4 hours.

Conclusion

In patients with obstructive uropathy with high risk of sepsis, length of stay would be decreased as time to percutaneous nephrostomy insertion shortened.

Funding

NO

Lead Authors

Ye Chan Joo, MD
Konyang University College of Medicine

Jae Hyun Baik, MD
Konyang University College of Medicine

Young Seop Chang, MD, PhD
Konyang University College of Medicine

Jin Bum Kim, MD, PhD
Konyang University College of Medicine

Hong Wook Kim, MD, PhD
Konyang University College of Medicine

Hyung Joon Kim, MD, PhD
Konyang University College of Medicine

Dong Hoon Koh, MD
Konyang University College of Medicine