Abdulrahman F Alruwaily1,2, Brian H Eisner3, Maggie J Bierlein1, Khurshid R Ghani1, J Stuart Wolf1, Brent K Hollenbeck1, John M Hollingsworth1. 1. 1 Department of Urology, Divisions of Endourology and Health Services Research, University of Michigan Medical School , Ann Arbor, Michigan. 2. 2 Department of Surgery, College of Medicine, Al-Imam Muhammad Ibn Saud Islamic University (IMSIU) , Riyadh, Saudi Arabia . 3. 3 Department of Urology, Harvard Medical School , Boston, Massachusetts.
Abstract
PURPOSE: To examine the association between statin medication use and sepsis risk after percutaneous nephrolithotomy (PCNL). MATERIALS AND METHODS: Using medical claims data, we identified working-age adults with urinary stone disease who were treated with PCNL. Among this cohort, we determined which patients had a prescription fill for a statin agent that encompassed their surgery date. We then fitted logistic regression models to examine for differences in rates of postoperative sepsis between statin users and nonusers. In addition, we evaluated the frequency of nonfebrile urinary tract infections (UTIs) and intensive care unit (ICU) services utilization and hospital length of stay (LOS) as a function of statin use. RESULTS: During the study period, at total of 2046 patients underwent PCNL, 382 (18.7%) of whom had a prescription fill for a statin agent preceding their surgery. The overall rate of sepsis in this population was 3.8%. After adjusting for patient health status and sociodemographic factors, the rate of postoperative sepsis was comparable between statin users and nonusers (5.3% vs 3.5%, respectively; P=0.105). In addition, UTI and ICU utilization rates did not relate to statin use (P>0.05 for all associations). Adjusted hospital LOS was shorter among statin users, but the difference was clinically trivial (3.6 vs 4.1 days; P=0.007). CONCLUSIONS: Statin use is not associated with reductions in postoperative sepsis, nonfebrile UTIs, ICU utilization, or hospital LOS after PCNL. To increase the safety of PCNL, urologists will have to consider other processes of care (e.g., clinical care pathways).
PURPOSE: To examine the association between statin medication use and sepsis risk after percutaneous nephrolithotomy (PCNL). MATERIALS AND METHODS: Using medical claims data, we identified working-age adults with urinary stone disease who were treated with PCNL. Among this cohort, we determined which patients had a prescription fill for a statin agent that encompassed their surgery date. We then fitted logistic regression models to examine for differences in rates of postoperative sepsis between statin users and nonusers. In addition, we evaluated the frequency of nonfebrile urinary tract infections (UTIs) and intensive care unit (ICU) services utilization and hospital length of stay (LOS) as a function of statin use. RESULTS: During the study period, at total of 2046 patients underwent PCNL, 382 (18.7%) of whom had a prescription fill for a statin agent preceding their surgery. The overall rate of sepsis in this population was 3.8%. After adjusting for patient health status and sociodemographic factors, the rate of postoperative sepsis was comparable between statin users and nonusers (5.3% vs 3.5%, respectively; P=0.105). In addition, UTI and ICU utilization rates did not relate to statin use (P>0.05 for all associations). Adjusted hospital LOS was shorter among statin users, but the difference was clinically trivial (3.6 vs 4.1 days; P=0.007). CONCLUSIONS: Statin use is not associated with reductions in postoperative sepsis, nonfebrile UTIs, ICU utilization, or hospital LOS after PCNL. To increase the safety of PCNL, urologists will have to consider other processes of care (e.g., clinical care pathways).
Authors: Philip Plaeke; Joris G De Man; Samuel Coenen; Philippe G Jorens; Benedicte Y De Winter; Guy Hubens Journal: Surg Today Date: 2019-06-06 Impact factor: 2.549
Authors: Daniel A Wollin; Adrian D Joyce; Mantu Gupta; Michael Y C Wong; Pilar Laguna; Stavros Gravas; Jorge Gutierrez; Luigi Cormio; Kunjie Wang; Glenn M Preminger Journal: World J Urol Date: 2017-02-03 Impact factor: 4.226