Predictors of postoperative infectious complications after partial nephrectomy: Analysis at a referral institution
Objective: Infectious complications after partial nephrectomy (PN) remain a significant concern. We aimed to analyze predictive factors of postoperative infectious complications (PICs) occurring after PN. Methods: Data on patients undergoing PN for renal masses between January 2018 and May 2023 were...
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Elsevier
2025-04-01
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| Series: | Asian Journal of Urology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214388224000894 |
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| author | Riccardo Bertolo Francesco Ditonno Alessandro Veccia Francesca Montanaro Francesco Artoni Alberto Baielli Michele Boldini Davide Brusa Sonia Costantino Marcella Sibani Vincenzo De Marco Filippo Migliorini Antonio Benito Porcaro Riccardo Rizzetto Maria Angela Cerruto Riccardo Autorino Alessandro Antonelli |
| author_facet | Riccardo Bertolo Francesco Ditonno Alessandro Veccia Francesca Montanaro Francesco Artoni Alberto Baielli Michele Boldini Davide Brusa Sonia Costantino Marcella Sibani Vincenzo De Marco Filippo Migliorini Antonio Benito Porcaro Riccardo Rizzetto Maria Angela Cerruto Riccardo Autorino Alessandro Antonelli |
| author_sort | Riccardo Bertolo |
| collection | DOAJ |
| description | Objective: Infectious complications after partial nephrectomy (PN) remain a significant concern. We aimed to analyze predictive factors of postoperative infectious complications (PICs) occurring after PN. Methods: Data on patients undergoing PN for renal masses between January 2018 and May 2023 were retrieved from prospectively maintained institutional database and retrospectively analyzed. Patients were stratified into two groups based on the occurrence of PICs during admission for PN. A PIC was defined by clinical and/or imaging findings of an infectious process plus microbial isolation upon culture examination. Multivariable logistic regression analysis after adjusting for potential confounders evaluated predictors of a PIC. Results: Six-hundred and twenty-seven patients underwent PN; rough incidence of PICs was 11%, with median time to PIC onset of 1 (interquartile range 0–3) day. Compared to patients without PIC events, the PIC group showed a significantly higher proportion of open surgeries (54% vs. 20%, p<0.001), bleeding events (23% vs. 10%, p<0.01), postoperative transfusion (19% vs. 5.0%, p<0.001), and urinary leakage (4.2% vs. 0.18%, p=0.01), and a statistically significantly higher median hemoglobin drop from baseline (−2.6 g/dL vs. −1.7 g/dL, p=0.001). At multivariable logistic regression, the odds of experiencing a PIC were statistically significantly lower after minimally-invasive surgery compared to open surgery (odds ratio 0.32, 95% confidence interval 0.17–0.59), and higher for patients who received transfusion (odds ratio 1.68, 95% confidence interval 1.10–2.54). Conclusion: We underlined factors that impact the occurrence of PICs and, consequently, duration of hospitalization following PN. By addressing these predictors, clinicians can promote enhanced patient recovery. |
| format | Article |
| id | doaj-art-dacec6cc240b40f2b17735fcd0570b50 |
| institution | OA Journals |
| issn | 2214-3882 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Urology |
| spelling | doaj-art-dacec6cc240b40f2b17735fcd0570b502025-08-20T01:48:57ZengElsevierAsian Journal of Urology2214-38822025-04-0112223624310.1016/j.ajur.2024.06.002Predictors of postoperative infectious complications after partial nephrectomy: Analysis at a referral institutionRiccardo Bertolo0Francesco Ditonno1Alessandro Veccia2Francesca Montanaro3Francesco Artoni4Alberto Baielli5Michele Boldini6Davide Brusa7Sonia Costantino8Marcella Sibani9Vincenzo De Marco10Filippo Migliorini11Antonio Benito Porcaro12Riccardo Rizzetto13Maria Angela Cerruto14Riccardo Autorino15Alessandro Antonelli16Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Verona, Italy; Corresponding author.Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Verona, Italy; Department of Urology, Rush University Medical Center, Chicago, IL, USADepartment of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Verona, ItalyDepartment of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Verona, ItalyDepartment of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Verona, ItalyDepartment of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Verona, ItalyDepartment of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Verona, ItalyDepartment of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Verona, ItalyDepartment of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Verona, ItalyDivision of Infectious Diseases, Department of Diagnostic and Public Health, University of Verona, Verona, ItalyDepartment of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Verona, ItalyDepartment of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Verona, ItalyDepartment of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Verona, ItalyDepartment of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Verona, ItalyDepartment of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Verona, ItalyDepartment of Urology, Rush University Medical Center, Chicago, IL, USADepartment of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Verona, ItalyObjective: Infectious complications after partial nephrectomy (PN) remain a significant concern. We aimed to analyze predictive factors of postoperative infectious complications (PICs) occurring after PN. Methods: Data on patients undergoing PN for renal masses between January 2018 and May 2023 were retrieved from prospectively maintained institutional database and retrospectively analyzed. Patients were stratified into two groups based on the occurrence of PICs during admission for PN. A PIC was defined by clinical and/or imaging findings of an infectious process plus microbial isolation upon culture examination. Multivariable logistic regression analysis after adjusting for potential confounders evaluated predictors of a PIC. Results: Six-hundred and twenty-seven patients underwent PN; rough incidence of PICs was 11%, with median time to PIC onset of 1 (interquartile range 0–3) day. Compared to patients without PIC events, the PIC group showed a significantly higher proportion of open surgeries (54% vs. 20%, p<0.001), bleeding events (23% vs. 10%, p<0.01), postoperative transfusion (19% vs. 5.0%, p<0.001), and urinary leakage (4.2% vs. 0.18%, p=0.01), and a statistically significantly higher median hemoglobin drop from baseline (−2.6 g/dL vs. −1.7 g/dL, p=0.001). At multivariable logistic regression, the odds of experiencing a PIC were statistically significantly lower after minimally-invasive surgery compared to open surgery (odds ratio 0.32, 95% confidence interval 0.17–0.59), and higher for patients who received transfusion (odds ratio 1.68, 95% confidence interval 1.10–2.54). Conclusion: We underlined factors that impact the occurrence of PICs and, consequently, duration of hospitalization following PN. By addressing these predictors, clinicians can promote enhanced patient recovery.http://www.sciencedirect.com/science/article/pii/S2214388224000894NephrectomyRenal neoplasmInfectionComplication |
| spellingShingle | Riccardo Bertolo Francesco Ditonno Alessandro Veccia Francesca Montanaro Francesco Artoni Alberto Baielli Michele Boldini Davide Brusa Sonia Costantino Marcella Sibani Vincenzo De Marco Filippo Migliorini Antonio Benito Porcaro Riccardo Rizzetto Maria Angela Cerruto Riccardo Autorino Alessandro Antonelli Predictors of postoperative infectious complications after partial nephrectomy: Analysis at a referral institution Asian Journal of Urology Nephrectomy Renal neoplasm Infection Complication |
| title | Predictors of postoperative infectious complications after partial nephrectomy: Analysis at a referral institution |
| title_full | Predictors of postoperative infectious complications after partial nephrectomy: Analysis at a referral institution |
| title_fullStr | Predictors of postoperative infectious complications after partial nephrectomy: Analysis at a referral institution |
| title_full_unstemmed | Predictors of postoperative infectious complications after partial nephrectomy: Analysis at a referral institution |
| title_short | Predictors of postoperative infectious complications after partial nephrectomy: Analysis at a referral institution |
| title_sort | predictors of postoperative infectious complications after partial nephrectomy analysis at a referral institution |
| topic | Nephrectomy Renal neoplasm Infection Complication |
| url | http://www.sciencedirect.com/science/article/pii/S2214388224000894 |
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