Septic Shock Following Endoscopic Stone Surgery: Incidence, Clinical Characteristics, and Outcomes in a Retrospective Cohort Study

Öz

Abstract Aim/Objective: To evaluate the incidence, clinical characteristics, microbiological profile, and outcomes of septic shock requiring intensive care unit (ICU) admission following endoscopic stone surgery. Methods: Patients who underwent endoscopic stone surgery between January 2024 and January 2026 were retrospectively reviewed. Cases of septic shock requiring ICU admission within the first 7 postoperative days were identified. Demographic characteristics, comorbidities, perioperative variables, microbiological findings, APACHE II and SOFA scores at ICU admission, and 30-day mortality were analysed. Results: Among 3,702 patients who underwent endoscopic stone surgery, 21 developed septic shock requiring ICU admission, yielding an incidence of 0.57%. The affected patients had a mean age of 67.0 ± 11.9 years, and diabetes mellitus (57.1%) and hypertension (52.4%) were the most common comorbidities. Preoperative and postoperative urine cultures were positive in 61.9% and 71.4% of patients, respectively, with Escherichia coli being the predominant pathogen. The mean APACHE II and SOFA scores at ICU admission were 17.67 ± 6.82 and 7.57 ± 2.13, respectively. Non-invasive respiratory support was required in 23.8% of patients, whereas no patient required invasive mechanical ventilation. Renal replacement therapy and multiple organ dysfunction syndrome each occurred in 19.0% of patients. The 30-day mortality rate was 14.3%. Conclusion: Septic shock following endoscopic stone surgery is an uncommon but clinically significant complication. Although it occurred in only 0.57% of patients, it was associated with substantial organ support requirements and a 30-day mortality rate of 14.3%. Early recognition and intensive care management may help improve outcomes in affected patients.

Anahtar Kelimeler

• Septic Shock
• Urinary Calculi
• Endoscopy
• Postoperative Complications
• Intensive Care Units

Destekleyen Kurum

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Etik Beyan

Ethical approval was obtained from the Institutional Ethics Committee of Ankara Etlik City Hospital (Approval No. AESH-BADEK2-2026-213; Date: 17.02.2026).

Endoskopik Taş Cerrahisi Sonrası Septik Şok: Retrospektif Bir Kohort Çalışmasında İnsidans, Klinik Özellikler ve Sonuçlar

Öz

Öz Amaç: Endoskopik taş cerrahisi sonrası yoğun bakım ünitesi (YBÜ) yatışı gerektiren septik şokun insidansını, klinik özelliklerini, mikrobiyolojik profilini ve klinik sonuçlarını değerlendirmektir. Yöntem: Ocak 2024 ile Ocak 2026 tarihleri arasında endoskopik taş cerrahisi uygulanan hastalar retrospektif olarak incelendi. Postoperatif ilk 7 gün içinde YBÜ yatışı gerektiren septik şok olguları belirlendi. Demografik özellikler, komorbiditeler, perioperatif değişkenler, mikrobiyolojik bulgular, YBÜ kabulündeki APACHE II ve SOFA skorları ile 30 günlük mortalite verileri analiz edildi. Bulgular: Endoskopik taş cerrahisi uygulanan 3.702 hasta arasında, 21 hastada yoğun bakım ünitesi (YBÜ) yatışı gerektiren septik şok gelişmiş olup insidans %0,57 olarak bulunmuştur. Septik şok gelişen hastaların yaş ortalaması 67,0 ± 11,9 yıl olup, en sık görülen komorbiditeler diabetes mellitus (%57,1) ve hipertansiyon (%52,4) idi. Preoperatif ve postoperatif idrar kültürlerinde sırasıyla hastaların %61,9 ve %71,4’ünde üreme saptanmış olup, en sık izole edilen mikroorganizma Escherichia coli olmuştur. YBÜ kabulündeki ortalama APACHE II ve SOFA skorları sırasıyla 17,67 ± 6,82 ve 7,57 ± 2,13 olarak hesaplanmıştır. Hastaların %23,8’inde non-invaziv solunum desteği gereksinimi gelişirken, hiçbir hastada invaziv mekanik ventilasyon ihtiyacı olmamıştır. Renal replasman tedavisi ve çoklu organ disfonksiyon sendromu hastaların her birinde %19,0 oranında görülmüştür. Otuz günlük mortalite oranı %14,3 olarak saptanmıştır. Sonuç: Endoskopik taş cerrahisi sonrası gelişen septik şok nadir ancak klinik açıdan önemli bir komplikasyondur. Hastaların yalnızca %0,57’sinde görülmesine rağmen, önemli düzeyde organ destek tedavisi gereksinimi ve %14,3 oranında 30 günlük mortalite ile ilişkilidir. Erken tanı ve yoğun bakım yönetimi, etkilenen hastalarda klinik sonuçların iyileştirilmesine katkı sağlayabilir.

Anahtar Kelimeler

• Septik Şok
• Üriner Sistem Taşları
• Endoskopi
• Postoperatif Komplikasyonlar
• Yoğun Bakım Üniteleri

Destekleyen Kurum

Bu araştırma, kamu, ticari veya kar amacı gütmeyen sektörlerdeki fon sağlayan kuruluşlardan herhangi bir özel hibe almamıştır.

Etik Beyan

Ankara Etlik Şehir Hastanesi Kurumsal Etik Kurulu'ndan etik onay alınmıştır (Onay No: AESH-BADEK2-2026-213; Tarih: 17.02.2026).

Kaynakça

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