Urosepsis due to obstructive stones: Epidemiological data from a population‐based study in Sweden

TL;DR

This study examines the incidence and outcomes of urosepsis caused by obstructive kidney stones in Sweden, showing it mainly affects the elderly and can be fatal.

Contribution

The study provides the first population-based epidemiological data on urosepsis due to obstructive stones in Sweden.

Findings

The incidence of acute obstructive urinary tract infection was 11.8 per 100,000 inhabitants per year.

16% of patients required ICU admission, and 3% died, with four deaths from acute septic complications.

The condition predominantly affects elderly patients, with a median age of 68 years and 56% being women.

Abstract

The study's aim is to provide a population‐based description of the incidence, epidemiology, and clinical course of urinary tract infection or sepsis caused by ureteric stone obstruction. Although being a life‐threatening condition, there have been few epidemiological reports on this disease.

The Swedish National Patient Register and local hospital databases were used to identify all adults discharged from inpatient care, with a combination of the International Classification of Disease 10th revision codes for urolithiasis and urinary tract infection in the Region Västra Götaland in Sweden for 2 years. Exclusion criteria were ongoing treatment for a urinary stone, nonsignificant infection and no obstruction from the stone. Medical records were reviewed to collect descriptive statistics on patient characteristics and clinical outcomes until stone‐free.

The register and local hospital search identified 702 patients with a predefined combination of diagnostic codes; 387 were excluded, leaving 315 for analysis. The incidence of acute obstructive urinary tract infection was 11.8 per 100 000 inhabitants per year. The median age was 68 years, and 176 (56%) were women. Fifty patients (16%) required intensive care unit admission and eight (3%) died. Four of these deaths were from acute septic complications, while the others died waiting for definitive stone treatment.

Acute obstructive urinary tract infection mainly affects elderly patients and has a variable clinical course, which in severe cases demands intensive care and may even be fatal.

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