{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:43:45Z","timestamp":1760060625100,"version":"build-2065373602"},"reference-count":30,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T00:00:00Z","timestamp":1757289600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003411","name":"Gangneung Asan Hospital Medical Institute and the Asan Foundation","doi-asserted-by":"publisher","award":["2024II0006","NRF-2022R1F1A1071736"],"award-info":[{"award-number":["2024II0006","NRF-2022R1F1A1071736"]}],"id":[{"id":"10.13039\/501100003411","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Research Foundation of Korea","award":["2024II0006","NRF-2022R1F1A1071736"],"award-info":[{"award-number":["2024II0006","NRF-2022R1F1A1071736"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: To identify clinical predictors of early recovery in patients with stone-induced systemic inflammatory response syndrome (SIRS) undergoing emergency decompression and compare the short-term inflammatory and renal function outcomes between retrograde ureteral stenting (RUS) and percutaneous nephrostomy (PCN). Method: We retrospectively evaluated data from 178 patients with stone-induced SIRS who were treated with RUS (n = 98) or PCN (n = 80) between 2011 and 2020. Early recovery was defined as readiness for discharge or no fever relapse within 3 days after drainage. Results: Univariate and multivariate logistic regression analyses identified significant predictors, and clinical outcomes were compared based on drainage methods. Univariate analysis showed that diabetes mellitus (p = 0.009), mid (p = 0.014) and upper (p = 0.017) stone locations, stone size of 10\u201320 mm, and renal stones were associated with early recovery, whereas female sex (p = 0.01) predicted poorer outcomes. In multivariate analysis, diabetes mellitus (p = 0.031), as well as mid (p = 0.007) and upper (p = 0.026) stone locations, remained favorable predictors, and female sex (p = 0.036) remained a negative predictor. PCN was associated with a transient increase in leukocyte count but facilitated earlier creatinine recovery compared with RUS. Conclusions: Female sex was an independent predictor of failure to achieve early recovery after urgent decompression, whereas diabetes mellitus and proximal ureteral stone location were independent predictors of early recovery. Baseline clinical factors were the main determinants of early recovery, supporting management tailored to these factors.<\/jats:p>","DOI":"10.3390\/diagnostics15172282","type":"journal-article","created":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T08:40:15Z","timestamp":1757407215000},"page":"2282","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic Clinical Predictors of Early Recovery from Stone-Induced Systemic Inflammatory Response Syndrome After Urgent Decompression"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9675-123X","authenticated-orcid":false,"given":"Sungbin","family":"Yoon","sequence":"first","affiliation":[{"name":"Department of Nephrology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung 25440, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yeonuk","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Urology, Asan Medical Centre, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Han Kyu","family":"Chae","sequence":"additional","affiliation":[{"name":"Department of Urology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung 25440, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wook","family":"Nam","sequence":"additional","affiliation":[{"name":"Department of Urology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung 25440, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hoon","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung 25440, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Youngjong","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Radiology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung 25440, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5609-0485","authenticated-orcid":false,"given":"Sung Jin","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Urology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung 25440, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1089\/end.2015.0567","article-title":"Metabolic syndrome and kidney stone disease: A systematic review of literature","volume":"30","author":"Wong","year":"2016","journal-title":"J. Endourol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1089\/end.2017.0123","article-title":"Worldwide impact of warmer seasons on the incidence of renal colic and kidney stone disease: Evidence from a systematic review of literature","volume":"31","author":"Geraghty","year":"2017","journal-title":"J. Endourol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.eururo.2012.09.035","article-title":"Temporal trends, practice patterns, and treatment outcomes for infected upper urinary tract stones in the United States","volume":"64","author":"Sammon","year":"2013","journal-title":"Eur. Urol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1016\/j.juro.2014.09.009","article-title":"Institutional characteristics associated with receipt of emergency care for obstructive pyelonephritis at community hospitals","volume":"193","author":"Borofsky","year":"2015","journal-title":"J. Urol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1016\/j.juro.2012.09.088","article-title":"Surgical decompression is associated with decreased mortality in patients with sepsis and ureteral calculi","volume":"189","author":"Borofsky","year":"2013","journal-title":"J. Urol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1016\/j.euf.2021.02.014","article-title":"Predictors and strategies to avoid mortality following ureteroscopy for stone disease: A systematic review from European association of urologists sections of urolithiasis (EULIS) and Uro-technology (ESUT)","volume":"8","author":"Bhanot","year":"2022","journal-title":"Eur. Urol. Focus"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1007\/s11934-020-0969-2","article-title":"Predictors of urinary infections and urosepsis after ureteroscopy for stone disease: A systematic review from EAU section of urolithiasis (EULIS)","volume":"21","author":"Chugh","year":"2020","journal-title":"Curr. Urol. Rep."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1186\/s12894-020-00644-z","article-title":"Systemic inflammatory response syndrome in patients with acute obstructive upper tract urinary stone: A risk factor for urgent renal drainage and revisit to the emergency department","volume":"20","author":"Larkin","year":"2020","journal-title":"BMC Urol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1256","DOI":"10.1097\/JU.0000000000001182","article-title":"Delayed decompression of obstructing stones with urinary tract infection is associated with increased odds of death","volume":"204","author":"Haas","year":"2020","journal-title":"J. Urol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.juro.2016.01.056","article-title":"Early intervention during acute stone admissions: Revealing \u201cthe weekend effect\u201d in urological practice","volume":"196","author":"Blackwell","year":"2016","journal-title":"J. Urol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1089\/end.2009.0361","article-title":"Evidence-based drainage of infected hydronephrosis secondary to ureteric calculi","volume":"24","author":"Ramsey","year":"2010","journal-title":"J. Endourol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.1007\/s00345-022-03979-4","article-title":"Emergency upper urinary tract decompression: Double-J stent or nephrostomy? A European YAU\/ESUT\/EULIS\/BSIR survey among urologists and radiologists","volume":"40","author":"Pietropaolo","year":"2022","journal-title":"World J. Urol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1016\/S0022-5347(01)62511-4","article-title":"Optimal method of urgent decompression of the collecting system for obstruction and infection due to ureteral calculi","volume":"160","author":"Pearle","year":"1998","journal-title":"J. Urol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1017\/S1481803500013026","article-title":"Predicting intervention in renal colic patients after emergency department evaluation","volume":"7","author":"Papa","year":"2005","journal-title":"Can. J. Emerg. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.jemermed.2014.12.085","article-title":"Risk factors associated with urologic intervention in emergency department patients with suspected renal colic","volume":"49","author":"Yan","year":"2015","journal-title":"J. Emerg. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1089\/end.2019.0801","article-title":"Clinical outcome and prognostic factors of sepsis, septic shock and prolonged hospitalization, of patients presented with acute obstructive pyelonephritis","volume":"34","author":"Kozyrakis","year":"2020","journal-title":"J. Endourol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1111\/iju.12666","article-title":"Obstructive pyelonephritis as a result of urolithiasis in Japan: Diagnosis, treatment and prognosis","volume":"22","author":"Hamasuna","year":"2015","journal-title":"Int. J. Urol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1001\/archsurg.134.9.935","article-title":"Male gender is a risk factor for major infections after surgery","volume":"134","author":"Offner","year":"1999","journal-title":"Arch. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1089\/sur.2012.009","article-title":"Predictors of sepsis in moderately severely injured patients: An analysis of the National Trauma Data Bank","volume":"14","author":"Kisat","year":"2013","journal-title":"Surg. Infect. (Larchmt)"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1097\/SHK.0000000000001253","article-title":"Association of sex with clinical outcome in critically ill sepsis patients: A retrospective analysis of the large clinical database MIMIC-III","volume":"52","author":"Xu","year":"2019","journal-title":"Shock"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1186\/s13054-015-0873-1","article-title":"Gender differences in outcome and use of resources do exist in Swedish intensive care, but to no advantage for women of premenopausal age","volume":"19","author":"Samuelsson","year":"2015","journal-title":"Crit. Care"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1186\/s13054-023-04515-5","article-title":"Influence of gender on age-associated in-hospital mortality in patients with sepsis and septic shock: A prospective nationwide multicenter cohort study","volume":"27","author":"Ko","year":"2023","journal-title":"Crit. Care"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1786","DOI":"10.1378\/chest.07-0420","article-title":"Influence of gender on the outcome of severe sepsis: A reappraisal","volume":"132","author":"Adrie","year":"2007","journal-title":"Chest"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1001\/archinte.167.8.834","article-title":"Age- and sex-associated trends in bloodstream infection: A population-based study in Olmsted County, Minnesota","volume":"167","author":"Uslan","year":"2007","journal-title":"Arch. Intern. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e0028322","DOI":"10.1128\/iai.00283-22","article-title":"Sex and gender differences in bacterial infections","volume":"90","author":"Dias","year":"2022","journal-title":"Infect. Immun."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"271","DOI":"10.3389\/fendo.2017.00271","article-title":"Diabetes and sepsis: Risk, recurrence, and ruination","volume":"8","author":"Frydrych","year":"2017","journal-title":"Front. Endocrinol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1111\/j.1464-410X.2006.06513.x","article-title":"Current opinion amongst radiologists and urologists in the UK on percutaneous nephrostomy and ureteric stent insertion for acute renal unobstruction: Results of a postal survey","volume":"98","author":"Lynch","year":"2006","journal-title":"BJU Int."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"6613","DOI":"10.1038\/s41598-021-86136-y","article-title":"Percutaneous nephrostomy versus retrograde ureteral stenting for acute upper obstructive uropathy: A systematic review and meta-analysis","volume":"11","author":"Azwadi","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1467","DOI":"10.1089\/end.2020.1140","article-title":"Preoperative midstream urine cultures vs renal pelvic urine culture or stone culture in predicting systemic inflammatory response syndrome and urosepsis after percutaneous nephrolithotomy: A systematic review and meta-analysis","volume":"35","author":"Liu","year":"2021","journal-title":"J. Endourol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1111\/bju.13796","article-title":"Ureteric stent dwelling time: A risk factor for post-ureteroscopy sepsis","volume":"120","author":"Nevo","year":"2017","journal-title":"BJU Int."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/17\/2282\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:42:16Z","timestamp":1760035336000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/17\/2282"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,8]]},"references-count":30,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["diagnostics15172282"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15172282","relation":{},"ISSN":["2075-4418"],"issn-type":[{"type":"electronic","value":"2075-4418"}],"subject":[],"published":{"date-parts":[[2025,9,8]]}}}