Introduction
Materials and method
Search strategy
Inclusion and exclusion criteria
Data extraction and quality assessment
Statistical analyses
Results
Study | Study period | Design | Sample size, n | Patients with infectious complications, n (%) | Sample overall age | Risk factors |
---|---|---|---|---|---|---|
Akdeniz et al. [15] | 2015–2020 | Retrospective Case–control | 228 | 29 (12.7) | 48.5 | ABCQRT |
Budak et al. [11] | 2013–2018 | Retrospective Case–control | 222 | 38 (17.1) | 52.9 | ABFRT |
Cetinkaya et al. [16] | 2013–2015 | Retrospective Case–control | 192 | 41 (21.6) | 47.3 | ABCDLMRSTV |
Chan et al. [17] | 2005–2009 | Retrospective Case–control | 99 | 40 (40.4) | 52.6 | ABCDEFKNOPSTV |
Chen et al. [18] | 2016–2017 | Retrospective Case–control | 802 | 19 (2.4) | 52.0 | ABDEFJNRSV |
Chen et al. [19] | 2005–2007 | Retrospective Case–control | 209 | 49 (23.4) | 49.1 | FOQR |
Erdil et al. [20] | 2008–2011 | Retrospective Case–control | 317 | 53 (16.7) | 47.5 | ADFGHNQRSTV |
Gao et al. [21] | 2011–2018 | Retrospective cohort | 197 | 34 (35.1) | 48.7 | ABCDFKLOQRST |
He et al. [22] | 2014–2016 | Retrospective Case–control | 1030 | 108 (10.49) | 52.1 | ABCDFINOS |
Koras et al. [23] | Retrospective Case–control | 303 | 83 (27.4) | 46.4 | CFGHJQRSTV | |
Lojanapiwat et al. [24] | Retrospective Case–control | 200 | 56 (28) | 51.5 | ACDFGHSTU | |
Peng et al. [25] | 2016–2020 | Retrospective Case–control | 365 | 108 (29.6) | 53.9 | ABCDEFLMNSU |
Sen et al. [26] | Retrospective Case–control | 487 | 91 (18.7) | 48.5 | AFGHQRT | |
Tang et al. [27] | 2016–2020 | Retrospective Case–control | 758 | 97 (12.8) | 52.0 | ABCDFKLNPRS |
Wang et al. [28] | 2017–2019 | Retrospective Case–control | 246 | 15 (6.1) | 51.2 | ABDFO |
Xu et al. [29] | 2015–2018 | Retrospective Case–control | 556 | 123 (22.1) | 52.0 | ABEF |
Yang et al. [30] | 2010–2014 | Retrospective Case–control | 164 | 45 (27.4) | 51.1 | ABDNOSUV |
Zhu et al. [31] | 2017–2019 | Retrospective Case–control | 786 | 23 (2.9) | 55.5 | ABDINPQRSV |
Study | Preoperative antibiotic | PCNL type | Operative time | Patients with infectious complications, n (%) |
---|---|---|---|---|
Akdeniz et al. [15] | ( −) urine: a single dose of antibiotic prophylaxis | Standard-PCNL | 60 | 29 (12.7) |
Budak et al. [11] | ( +) urine:2 weeks targeted treatment ( −) urine: Intraoperative IV cefuroxime or ciprofloxacin | Standard-PCNL | 88 | 38 (17.1) |
Cetinkaya et al. [16] | ( +) urine: treated with antimicrobials | Standard-PCNL | 52 | 41 (21.6) |
Chan et al. [17] | ( +) urine: treated with antimicrobials | Standard-PCNL | 225.7 | 40 (40.4) |
Chen et al. [18] | ( +) urine:3–14 days targeted treatment ( −) urine: a single dose of antibiotic prophylaxis | Standard-PCNL | 98.4 | 19 (2.4) |
Chen et al. [19] | All patients:7 days ciprofloxacin 250 mg twice daily 、Intraoperative IV ceftriaxone 2.0 g | Standard-PCNL | 105 | 49 (23.4) |
Erdil et al. [20] | ( +) urine:7 days targeted treatment ( −) urine: Intraoperative IV ceftriaxone 1 g | Standard-PCNL | 81.7 | 53 (16.7) |
Gao et al. [21] | ( +) urine: targeted treatment ( −) urine: Preoperative IV second-generation cephalosporin | Standard-PCNL | 104.1 | 34 (35.1) |
He et al. [22] | ( +) urine:7 days targeted treatment ( −) urine: Preoperative IV cefathiamidine | 153 | 108 (10.49) | |
Koras et al. [23] | ( +) urine:7 days targeted treatment ( −) urine: a single dose of antibiotic prophylaxis | Standard-PCNL | 119.2 | 83 (27.4) |
Lojanapiwat et al. [24] | ( +) urine:2 days targeted treatment ( −) urine: Intraoperative IV ceftriaxone 2 g | Standard-PCNL | 51.7 | 56 (28) |
Peng et al. [25] | ( +) urine:7 days targeted treatment ( −) urine: Preoperative IV cefamezin 1 g | Standard-PCNL | 83.8 | 108 (29.6) |
Sen et al. [26] | ( +) urine:7 days targeted treatment ( −) urine: a single dose of antibiotic prophylaxis | Standard-PCNL | 108.1 | 91 (18.7) |
Tang et al. [27] | All patients: Intraoperative treated with antimicrobials | Standard-PCNL | 119.6 | 97 (12.8) |
Wang et al. [28] | ( +) urine: targeted treatment | Standard-PCNL | 87.9 | 15 (6.1) |
Xu et al. [29] | ( +) urine:7 days targeted treatment ( −) urine: Preoperative IV moxifloxacin 0.4 g | 123 (22.1) | ||
Yang et al. [30] | ( +) urine: targeted treatment | 133.7 | 45 (27.4) | |
Zhu et al. [31] | ( −) urine: a single dose of antibiotic prophylaxis | Mini-PCNL | 90.3 | 23 (2.9) |
Risk factor | No. of studies | Statistic | OR\MD (95% CI) | P | |
---|---|---|---|---|---|
Demographic Factors | Gender | 16 | OR | 1.60 [1.23, 2.07] | < 0.001 |
Diabetes | 13 | OR | 1.55 [1.10, 2.20] | = 0.01 | |
BMI | 10 | MD | − 0.56 [− 0.88, − 0.24] | < 0.001 | |
Age | 13 | MD | 0.43 [− 0.62, 1.47] | = 0.42 | |
Hypertension | 4 | OR | 1.15 [0.86, 1.55] | = 0.34 | |
Laboratory Testing | UC | 14 | OR | 3.16 [2.11, 4.74] | < 0.001 |
Factors | RPUC | 4 | OR | 5.81 [1.75, 19.32] | = 0.004 |
SC | 4 | OR | 5.11 [1.46, 17.89] | = 0.01 | |
Urine leukocyte | 2 | OR | 3.61 [2.45, 5.34] | < 0.001 | |
Infected stone | 2 | OR | 7.00 [1.27, 38.55] | = 0.03 | |
Peripheral blood leukocyte | 3 | MD | 0.71 [0.31, 1.10] | < 0.001 | |
NLR | 4 | MD | 0.55 [0.43, 0.66] | < 0.001 | |
PLR | 2 | MD | 19.32 [− 7.22, 45.86] | = 0.15 | |
Creatinine | 8 | MD | 0.13 [− 4.72, 4.98] | = 0.96 | |
Perioperative | Staghorn stone | 6 | OR | 3.07 [1.32, 7.11] | = 0.009 |
Factors | Preoperative stent placement | 3 | OR | 2.04 [1.07, 3.88] | = 0.03 |
Blood transfusion | 7 | OR | 3.63 [1.98, 6.65] | < 0.001 | |
Access number | 11 | OR | 2.58 [1.75, 3.82] | < 0.001 | |
Operative time | 12 | MD | 10.20 [4.80, 15.60] | < 0.001 | |
Residual stone | 9 | OR | 1.56 [1.24, 1.98] | < 0.001 | |
Stone size | 3 | MD | 0.22 [− 0.04, 0.48] | = 0.1 | |
Hydronephrosis | 7 | OR | 1.21 [0.90, 1.63] | = 0.21 |
Study | Selection | Comparability | Exposure | NOS |
---|---|---|---|---|
Akdeniz et al. [15] | ☆☆☆ | ☆ | ☆☆ | 6 |
Budak et al. [11] | ☆☆☆ | ☆☆ | ☆☆ | 7 |
Cetinkaya et al. [16] | ☆☆☆ | ☆ | ☆☆ | 6 |
Chan et al. [17] | ☆☆☆ | ☆☆ | 5 | |
Chen et al. [14] | ☆☆☆ | ☆☆ | ☆☆ | 7 |
Chen et al. [15] | ☆☆☆ | ☆☆ | ☆☆ | 7 |
Erdil et al. [20] | ☆☆☆ | ☆☆ | ☆☆ | 7 |
Gao et al. [21] | ☆☆☆ | ☆☆ | ☆☆ | 7 |
He et al. [18] | ☆☆☆ | ☆ | ☆☆ | 6 |
Koras et al. [23] | ☆☆ | ☆☆ | ☆☆ | 6 |
Lojanapiwat et al. [24] | ☆☆ | ☆☆ | ☆☆ | 6 |
Peng et al. [25] | ☆☆☆ | ☆ | ☆☆ | 6 |
Sen et al. [26] | ☆☆ | ☆ | ☆☆ | 5 |
Tang et al. [27] | ☆☆☆ | ☆ | ☆☆ | 6 |
Wang et al. [28] | ☆☆☆ | ☆ | ☆☆ | 6 |
Xu et al. [29] | ☆☆☆ | ☆ | ☆☆ | 6 |
Yang et al. [30] | ☆☆☆ | ☆ | ☆☆ | 6 |
Zhu et al. [31] | ☆☆☆ | ☆ | ☆☆ | 6 |
Demographic factors
Laboratory testing factors
Research factors | Remove documents | Before removing | After removing | |||||||||
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I2 | P | Model | OR\MD (95% CI) | P | I2 | P | Model | OR\MD (95% CI) | P | |||
Demographic | Gender | Sen et al. [26] | 62% | <0.001 | Random Effect Model | 1.60 [1.23, 2.07] | < 0.001 | 21% | = 0.22 | Random Effect Model | 1.79 [1.49, 2.15] | < 0.001 |
Factors | Diabetes | Peng et al. [25] | 44% | = 0.05 | Random Effect Model | 1.55[1.10, 2.20] | = 0.01 | 28% | = 0.17 | Random Effect Model | 1.73 [1.25, 2.39] | < 0.001 |
Laboratory Testing | UC | None | 81% | <0.001 | Random Effect Model | 3.16 [2.11, 4.74] | < 0.001 | 81% | <0.001 | Random Effect Model | 3.16 [2.11, 4.74] | < 0.001 |
Factors | RPUC | 83% | <0.001 | Random Effect Model | 5.81 [1.75, 19.32] | =0.004 | 0% | =0.43 | Random Effect Model | 5.97 [3.01, 11.81] | < 0.001 | |
SC | 89% | <0.001 | Random Effect Model | 5.11 [1.46, 17.89] | =0.01 | 50% | =0.16 | Random Effect Model | 15.34 [5.53, 42.56] | <0.001 | ||
Perioperative | Staghorn stone | Wang et al. [28] | 83% | <0.001 | Random Effect Model | 3.07 [1.32, 7.11] | =0.009 | 27% | =0.24 | Random Effect Model | 2.00 [1.35, 2.97] | < 0.001 |
Factors | Blood transfusion | Chen et al. [19] | 52% | =0.05 | Random Effect Model | 3.63 [1.98, 6.65] | < 0.001 | 19% | =0.29 | Random Effect Model | 2.92 [1.85, 4.61] | < 0.001 |
Access number | 59% | =0.006 | Random Effect Model | 2.58 [1.75, 3.82] | < 0.001 | 0% | =0.57 | Random Effect Model | 2.34 [1.79, 3.05] | < 0.001 | ||
Operative time | 64% | =0.001 | Random Effect Model | 10.20 [4.80, 15.60] | < 0.001 | 43% | =0.07 | Random Effect Model | 10.08 [4.98, 15.18] | < 0.001 | ||
Stone size | Peng et al. [25] | 51% | =0.31 | Random Effect Model | 0.22 [-0.04, 0.48] | =0.1 | 21% | =0.57 | Random Effect Model | 0.38 [0.03, 0.73] | =0.03 |
Perioperative factors
Subgroup analysis
Risk factor | Subgroup | No. of studies, n | Heterogeneity I2, %p value | OR/MD (95% CI) | p value |
---|---|---|---|---|---|
Gender | Urosepsis | 4 | 00.4 | 2.48 [1.54, 3.99] | < 0.01 |
SIRS | 11 | 69 < 0.01 | 1.40 [1.03, 1.89] | 0.03 | |
FUTI | 1 | NANA | 2.26 [1.11, 4.59] | 0.02 | |
Diabetes | Urosepsis | 4 | 350.2 | 1.97 [0.91, 4.26] | 0.09 |
SIRS | 8 | 530.04 | 1.39 [0.89, 2.17] | 0.15 | |
FUTI | 1 | NANA | 1.83 [0.85, 3.97] | 0.12 | |
BMI | Urosepsis | 1 | NANA | -0.54 [-1.83, 0.75] | 0.41 |
SIRS | 8 | 00.51 | -0.56 [-0.90, -0.23] | < 0.01 | |
Age | Urosepsis | 4 | 410.16 | 2.65 [0.04, 5.27] | 0.05 |
SIRS | 9 | 210.26 | 0.00 [-1.14, 1.14] | 0.99 | |
Hypertension | Urosepsis | 1 | NANA | 0.34 [0.08, 1.48] | 0.15 |
SIRS | 3 | 00.98 | 1.25 [0.92, 1.69] | 0.15 | |
UC | Urosepsis | 3 | 88 < 0.01 | 8.82 [1.56, 49.94] | 0.01 |
SIRS | 10 | 77 < 0.01 | 2.78 [1.87, 4.14] | < 0.01 | |
FUTI | 1 | NANA | 1.29 [0.58, 2.87] | 0.54 | |
RPUC | SIRS | 4 | 83 < 0.01 | 5.81 [1.75, 19.32] | < 0.01 |
SC | SIRS | 4 | 89 < 0.01 | 5.11 [1.46, 17.89] | 0.01 |
Urine leukocyte | Urosepsis | 1 | NANA | 2.37 [0.80, 7.04] | 0.12 |
SIRS | 1 | NANA | 3.92 [2.60, 5.90] | < 0.01 | |
Infected stone | Urosepsis | 1 | NANA | 3.29 [1.32, 8.24] | 0.01 |
SIRS | 1 | NANA | 18.42 [4.03, 84.29] | < 0.01 | |
Peripheral blood leukocyte | Urosepsis | 1 | NANA | 0.22 [-0.50, 0.94] | 0.55 |
SIRS | 2 | 00.93 | 3.29 [1.32, 8.24] | < 0.01 | |
NLR | Urosepsis | 1 | NANA | 0.82 [-0.39, 2.03] | 0.18 |
SIRS | 3 | 00.8 | 0.22 [-0.50, 0.94] | < 0.01 | |
PLR | SIRS | 2 | 88 < 0.01 | 19.32 [-7.22, 45.86] | 0.15 |
Creatinine | Urosepsis | 2 | 80.3 | 5.29 [-11.50, 22.08] | 0.54 |
SIRS | 6 | 00.89 | -0.34 [-5.40, 4.73] | 0.9 | |
Staghorn stone | Urosepsis | 2 | 94 < 0.01 | 11.27 [0.43, 295.33] | 0.15 |
SIRS | 4 | 450.14 | 5.29 [-11.50, 22.08] | 0.01 | |
Preoperative stent placement | Urosepsis | 1 | NANA | 1.50 [0.50, 4.50] | 0.47 |
SIRS | 2 | 700.07 | 2.42 [1.08, 5.42] | 0.03 | |
Blood transfusion | Urosepsis | 2 | 600.11 | 2.37 [0.27, 20.91] | 0.44 |
SIRS | 5 | 580.05 | 3.99 [2.09, 7.61] | < 0.01 | |
Access number | Urosepsis | 3 | 60.34 | 2.48 [1.30, 4.76] | < 0.01 |
SIRS | 7 | 72 < 0.01 | 2.93 [1.70, 5.03] | < 0.01 | |
FUTI | 1 | NANA | 1.60 [0.79, 3.26] | 0.19 | |
Operative time | Urosepsis | 3 | 480.15 | 9.19 [3.13, 15.25] | 0.02 |
SIRS | 9 | 67 < 0.01 | 9.19 [3.13, 15.25] | < 0.01 | |
Residual stone | Urosepsis | 1 | NANA | 2.32 [0.96, 5.61] | 0.06 |
SIRS | 7 | 40.4 | 1.54 [1.19, 2.00] | < 0.01 | |
FUTI | 1 | NANA | 1.33 [0.64, 2.77] | 0.44 | |
Stone size | SIRS | 3 | 510.13 | 0.22 [-0.04, 0.48] | 0.1 |
Hydronephrosis | Urosepsis | 2 | 00.55 | 1.61 [0.77, 3.36] | 0.2 |
SIRS | 5 | 330.2 | 1.14 [0.83, 1.58] | 0.42 |