Analysis of Risk Factors for Urosepsis in Patients with Type 2 Diabetes Complicated by Upper Urinary Tract Stones: A Single-Centre Retrospective Study.

BACKGROUND

Urosepsis represents a complication of upper urinary tract stones (UUTSs) in patients with type 2 diabetes mellitus (T2DM), thus necessitating a comprehensive understanding of risk factors. This single-centre retrospective study aimed to analyse the risk factors for urosepsis in this patient population.

METHODS

Clinical data of patients with UUTS and T2DM admitted from January 2015 to January 2024 were collected and retrospectively analysed. Laboratory parameters, including white blood cell (WBC) count, serum creatinine, urine culture, C-reactive protein and imaging findings were assessed. Stepwise backward selection and logistic regression analysis was used to explore the risk factors of urosepsis.

RESULTS

A total of 108 patients, including 56 patients complicated with urosepsis and 52 without urosepsis, were included. The urosepsis group exhibited significantly increased white blood cell count (15.75 ± 2.58 vs. 14.63 ± 2.76, p = 0.031), colony-forming units per millilitre in urine culture (5000.46 ± 1200.56 vs. 4570.13 ± 1000.24, p = 0.045), serum C-reactive protein levels (43.02 ± 12.36 vs. 38.54 ± 10.75, p = 0.047), presence of hydronephrosis (82.14% vs. 63.46%, p = 0.049) , ureteral stricture (46.43% vs. 25.00%, p = 0.034), prevalence of Gram-negative bacteria (85.71% vs. 67.31%, p = 0.042), antibiotic resistance (37.50% vs. 17.31%, p = 0.034), and empirical antibiotic use (62.50% vs. 40.38%, p = 0.035) compared with the non-urosepsis group. Gram-negative bacteria (odds ratio (OR) = 2.914, p = 0.027), antibiotic resistance (OR = 2.867, p = 0.022), renal hydronephrosis (OR = 2.648, p = 0.031), urethral stricture (OR = 2.600, p = 0.022) and antibiotic usage history (OR = 2.460, p = 0.023) exhibited significant OR values, whereas white blood cell (WBC) count demonstrated a moderate OR value (OR = 1.175, p = 0.034). These findings further underscore their potential to be reasonably predictive risk factors for urosepsis.

CONCLUSIONS

This study identified various risk factors associated with urosepsis in patients with T2DM and UUTS. Laboratory parameters, imaging findings and urinary tract infection characteristics were found to be significant contributors to the development of urosepsis in this patient population.