TY  - JOUR
T1  - Nephrostomy-Associated Sepsis in Cancer Patients: What Are the Risk Factors? A Retrospective Cohort Study
AU  - Uğur, Ramazan
AU  - Keskin, Emin Taha
AU  - Özdemir, Turan
AU  - Sağir, Ahmet Eren
AU  - Özbörü, Direnç
AU  - Zilan, Abdullah
AU  - Şimşek, Abdülmüttalip
PY  - 2025
DA  - October
Y2  - 2025
DO  - 10.33719/nju1660320
JF  - The New Journal of Urology
JO  - New J Urol
PB  - Ali İhsan TAŞÇI
WT  - DergiPark
SN  - 3023-6940
SP  - 149
EP  - 158
VL  - 20
IS  - 3
LA  - en
AB  - Objective: To evaluate sepsis and mortality following nephrostomy tube due to malignant etiology.Material and Methods: Patients who underwent nephrostomy tube at our center were retrospectively evaluated. Only those with malignancy-related indications were included in the study. Patients were initially categorized into two main groups: those with urological malignancies and those with non-urological malignancies. Subsequently, they were further divided into subgroups based on the development of sepsis and survival status. Predictive factors associated with sepsis and mortality were analyzed.Results:A total of 517 patients were identified, of whom 173 met the inclusion criteria. The mean age was 62.53 years, with a male-to-female ratio of 112:61. Among patients who developed sepsis, post-operative (post-op) platelet counts, post-op creatinine, as well as pre-operative (pre-op) and post-op neutrophil and lymphocyte counts and neutrophil-to-lymphocyte ratio (NLR) were significantly lower, whereas procalcitonin and C-reactive protein (CRP) levels were significantly higher (p<0.05). The presence of perirenal fat stranding and intensive care unit (ICU) admission were also significantly associated with sepsis development(p<0.05). Regarding mortality, lower pre-op and post-op lymphocyte counts and higher procalcitonin levels were statistically significant (p <0.05). Postoperative NLR, creatinine and CRP were also significantly associated with mortality. Furthermore, the presence of diabetes mellitus (DM), immunosuppressive drug use (ISDU), ICU admission, and non-urological malignancies were found to be statistically significant factors associated with mortality.Conclusion:Our findings indicate that NLR, procalcitonin, CRP, as well as pre-and post-op platelet, lymphocyte and neutrophil counts, along with the presence of perirenal fat stranding, DM, ISDU, and ICU admission and non-urological malignancies play significant roles in the development of sepsis and mortality. These findings emphasize the importance of early risk stratification and targeted management in patients undergoing nephrostomy for malignant obstruction.
KW  - malignancy
KW  - mortality
KW  - percutaneous nephrostomy
KW  - sepsis
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UR  - https://doi.org/10.33719/nju1660320
L1  - https://dergipark.org.tr/en/download/article-file/4701595
ER  -