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Original Paper

Lithotrites and Postoperative Fever: Does Lithotrite Type Matter? Results from the Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study

Chu D.I.a · Lipkin M.E.a · Wang A.J.a · Ferrandino M.N.a · Preminger G.M.a · Kijvikai K.b · Gupta N.P.c · Melekos M.D.d · de la Rosette J.J.M.C.H.e · on behalf of the CROES Global PCNL study group

Author affiliations

aComprehensive Kidney Stone Center, Duke University Medical Center, Durham, N.C., USA; bRamathibodi Hospital, Mahidol University, Bangkok, Thailand; cAll India Institute of Medical Sciences, New Delhi, India; dDepartment of Urology, University of Thessaly, Larissa, Greece; eAMC University Hospital, Amsterdam, The Netherlands

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Urol Int 2013;91:340-344

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: February 19, 2013
Accepted: April 22, 2013
Published online: August 08, 2013
Issue release date: October 2013

Number of Print Pages: 5
Number of Figures: 0
Number of Tables: 4

ISSN: 0042-1138 (Print)
eISSN: 1423-0399 (Online)

For additional information: https://www.karger.com/UIN

Abstract

Objective: To compare the risks of fever from different lithotrites after percutaneous nephrolithotomy (PNL). Materials and Methods: The Clinical Research Office of the Endourological Society (CROES) PNL database is a prospective, multi-institutional, international PNL registry. Of 5,803 total patients, 4,968 received preoperative antibiotics, were supplied with complete information and included in this analysis. The lithotrites assessed included no fragmentation, ultrasonic, laser, pneumatic and combination ultrasonic/pneumatic. Risk of fever was estimated using multivariate logistic regression with adjustment for diabetes, steroid use, a history of positive urine culture, the presence of staghorn calculi or preoperative nephrostomy, stone burden and lithotrite. Results: The overall fever rate was 10%. Pneumatic lithotrites were used in 43% of the cohort, followed by ultrasonic (24%), combination ultrasonic/pneumatic (17.3%), no fragmentation (8.4%) and laser (7.3%). Fever rates were no different between patients who underwent no or any fragmentation (p = 0.117), nor among patients when stratified by lithotrite (p = 0.429). On multivariate analysis, fragmentation was not significantly associated with fever [Odds Ratio (OR) 1.17, p = 0.413], while diabetes (OR 1.32, p = 0.048), positive urine culture (OR 2.08, p < 0.001), staghorn calculi (OR 1.80, p < 0.001) and nephrostomy (OR 1.65, p < 0.001) increased fever risk. Fever risk among lithotrites did not differ (p ≥ 0.128). Conclusions: Risk of post-PNL fever was not significantly different among the various lithotrites used in the CROES PNL study.

© 2013 S. Karger AG, Basel


References

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    External Resources
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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: February 19, 2013
Accepted: April 22, 2013
Published online: August 08, 2013
Issue release date: October 2013

Number of Print Pages: 5
Number of Figures: 0
Number of Tables: 4

ISSN: 0042-1138 (Print)
eISSN: 1423-0399 (Online)

For additional information: https://www.karger.com/UIN


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