Nephrostomy-Associated Sepsis in Cancer Patients: What Are the Risk Factors? A Retrospective Cohort Study

Year 2025, Volume: 20 Issue: 3, 149 - 158, 20.10.2025

Ramazan Uğur , Emin Taha Keskin , Turan Özdemir , Ahmet Eren Sağir , Direnç Özbörü , Abdullah Zilan , Abdülmüttalip Şimşek

https://doi.org/10.33719/nju1660320

Abstract

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.

Keywords

malignancy , mortality , percutaneous nephrostomy , sepsis

Ethical Statement

The study was approved by the Ethics Committee of Başakşehir Çam and City Hospital (Approval No: 2023-183)

Supporting Institution

The authors declared that this study has received no financial support.

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