META-ANALYSIS OF RISK FACTORS FOR URINARY SEPSIS IN ATHLETES FOLLOWING PERCUTANEOUS NEPHROLITHOTOMY

Abstract

Objective: To investigate the risk factors for urosepsis (US) following percutaneous nephrolithotomy (PCNL) specifically in athletes, using a meta-analysis and retrospective study approach. Methods: A comprehensive literature search was conducted, gathering data from studies published between January 2010 and June 2022 across PubMed, The Cochrane Library, and Embase. The search terms included "percutaneous nephrolithotomy," "sepsis," "urosepsis," "risk factors," and "kidney stones," tailored to identify studies relevant to athletes. Sixteen high-quality case-control studies were selected, encompassing data from 5,986 patients. Results: The analysis identified eight independent risk factors for the development of urosepsis in athletes post-PCNL, including positive urine culture, presence of urinary nitrite, prolonged operation time, preoperative elevated leukocyte counts, type of kidney stones (infectious, antler, high-load), and patient gender. These factors were significantly associated with increased risk of urosepsis after PCNL. Conclusion: This meta-analysis highlights specific risk factors that contribute to the incidence of urosepsis following PCNL in athletes. Recognizing these risk factors is crucial for improving preoperative assessment and postoperative care in this population. Enhanced screening and targeted preventive measures should be considered for athletes undergoing PCNL to mitigate the risk of urosepsis, thereby optimizing recovery and minimizing complications associated with this procedure.