Yeungnam Univ J Med.  2021 Jul;38(3):225-230. 10.12701/yujm.2021.00955.

Significance of albumin to globulin ratio as a predictor of febrile urinary tract infection after ureteroscopic lithotripsy

Affiliations
  • 1Department of Urology, Kyungpook National University Hospital, Daegu, Korea
  • 2Department of Urology, Dongguk University Gyeonju Hospital, Gyeongju, Korea
  • 3Department of Urology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Korea
  • 4Department of Urology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea

Abstract

Background
We aimed to analyze the effectiveness of albumin to globulin ratio (AGR) in predicting postoperative febrile urinary tract infection (fUTI) after ureteroscopic lithotripsy (URS) and retrograde intrarenal surgery (RIRS).
Methods
From January 2013 to May 2018, 332 patients underwent URS and RIRS. The rate of postoperative fUTI and risk factors for postoperative fUTI were analyzed using logistic regression. Patients were divided into postoperative fUTI and non-postoperative fUTI (non-fUTI) groups. AGR with other demographic and perioperative data were compared between the two groups to predict the development of fUTI after URS.
Results
Of the 332 patients, postoperative fUTI occurred in 41 (12.3%). Preoperative pyuria, microscopic hematuria, diabetes mellitus, hypoalbuminemia, and hyperglobulinemia were more prevalent in the fUTI group. Patients in the fUTI group had larger stone size, lower preoperative AGR, longer operation time, and longer preoperative antibiotic coverage period. In a multivariable logistic analysis, preoperative pyuria, AGR, and stone size were independently correlated with postoperative fUTI (p<0.001, p=0.008, and p=0.041, respectively). Receiver operating curve analysis showed that the cutoff value of AGR that could predict a high risk of fUTI after URS was 1.437 (sensitivity, 77.3%; specificity, 76.9%), while the cutoff value of stone size was 8.5 mm (sensitivity, 55.3%; specificity, 44.7%).
Conclusion
This study demonstrated that preoperative pyuria, AGR, and stone size can serve as prognostic factors for predicting fUTI after URS.

Keyword

Albumin to globulin ratio; Ureteroscopy; Urinary tract infections; Nephrolithiasis; Biomarkers
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