Preoperative Prediction of Urosepsis Following Decompression of Obstructed Infected Upper Urinary Tract: A Cross Sectional Study

Abstract

Objectives: To determine the preoperative clinical and laboratory predictors of urosepsis following decompression of an obstructed infected upper urinary tract.

Materials and Methods:  Ethical approval was obtained from Shaheed Saif ur Rehman Government Teaching Hospital Gilgit and Regional Headquarter Hospital, Skardu. After informed consent, eligible patients were enrolled and demographic, clinical, laboratory, imaging, decompression, and culture data were recorded using a structured questionnaire. Patients were subsequently monitored after decompression for development of urosepsis. Data were entered and analyzed using SPSS.

Results: Among 130 patients, mean age was 48.6±14.2 years, with 58.5% males and 41.5% females. Diabetes was present in 30.0% and CKD in 13.8%. Fever, tachycardia, pyuria, and positive urine culture were present in 64.6%, 43.8%, 72.3%, and 46.9%, respectively. Hydronephrosis was present in all patients, mainly due to ureteric stones (80.8%), and 68.5% underwent DJ stenting. Urosepsis developed in 32 (24.6%) patients. Those with urosepsis were older and had significantly higher rates of female sex, diabetes, fever, tachycardia, pyuria, leukocytosis, elevated creatinine, and positive urine cultures.

Conclusion: It was concluded that Urosepsis developed in 24.6% of patients after decompression. Older age, female sex, diabetes, fever, tachycardia, elevated leukocyte and creatinine levels, pyuria, and positive urine cultures were significant predictors, enabling early identification and closer monitoring of high-risk patients.