MP23-10 STONE CULTURE SPECIES AND RISK OF SEPSIS AFTER PERCUTANEOUS NEPHROLITHOTOMY: A STUDY FROM THE EDGE RESEARCH CONSORTIUM
Bibliographic record
Abstract
You have accessJournal of UrologyStone Disease: Surgical Therapy III (MP23)1 Apr 2019MP23-10 STONE CULTURE SPECIES AND RISK OF SEPSIS AFTER PERCUTANEOUS NEPHROLITHOTOMY: A STUDY FROM THE EDGE RESEARCH CONSORTIUM Carlos Mejia Arbelaez*, Alan Yaghoubian, Timothy Batter, Dianne Sacco, Ben Chew, Manoj Monga, Amy Krambeck, Roger Sur, Bodo Knudsen, Nina Mikkilineni, Ojas Shah, Karen Stern, Smita De, Nicole Miller, Tatevik Broutian, Michael Sourial, Justin Rose, Tim Large, Kymora Scotland, Colin Lundeen, Dirk Lange, Thomas DiPina, Seth Bechis, and Brian Eisner Carlos Mejia Arbelaez*Carlos Mejia Arbelaez* More articles by this author , Alan YaghoubianAlan Yaghoubian More articles by this author , Timothy BatterTimothy Batter More articles by this author , Dianne SaccoDianne Sacco More articles by this author , Ben ChewBen Chew More articles by this author , Manoj MongaManoj Monga More articles by this author , Amy KrambeckAmy Krambeck More articles by this author , Roger SurRoger Sur More articles by this author , Bodo KnudsenBodo Knudsen More articles by this author , Nina MikkilineniNina Mikkilineni More articles by this author , Ojas ShahOjas Shah More articles by this author , Karen SternKaren Stern More articles by this author , Smita DeSmita De More articles by this author , Nicole MillerNicole Miller More articles by this author , Tatevik BroutianTatevik Broutian More articles by this author , Michael SourialMichael Sourial More articles by this author , Justin RoseJustin Rose More articles by this author , Tim LargeTim Large More articles by this author , Kymora ScotlandKymora Scotland More articles by this author , Colin LundeenColin Lundeen More articles by this author , Dirk LangeDirk Lange More articles by this author , Thomas DiPinaThomas DiPina More articles by this author , Seth BechisSeth Bechis More articles by this author , and Brian EisnerBrian Eisner More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000555616.97678.f1AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: In recent years, obtaining stone culture has become common practice during percutaneous nephrolithotomy (PCNL) as it most accurately predicts bacteria responsible for post-operative sepsis. However, to date, no studies have performed a detailed analysis of the relationship between specific bacterial species and risk of sepsis after PCNL. METHODS: A retrospective review of 340 PCNL procedures was performed. We used the qSOFA (quick sequential organ failure assessment), a scoring system recently devised for the prediction of sepsis risk which has been shown in multiple studies to be more accurate than SIRS criteria. Inclusion criteria were stone culture species minimum number of 10; all stone culture species with < 10 incidents in our database were excluded due to lack of data. RESULTS: Three-hundred twenty-five patients (325) met inclusion criteria. The percentage of patients with each stone culture species that met qSOFA criteria (i.e. had increased risk of sepsis) after PCNL were as follows: negative stone culture = 10%, candida = 0%, e. coli = 6.3%, enterococcus = 8.1%, klebsiella = 0%, proteus = 40%, providencia = 0%, pseudomonas = 15.4%, staphylococcus species = 9.5%. CONCLUSIONS: In this multi-center study, we demonstrate that stone culture species may be related to risk of development of sepsis . Certain bacteria appear to be more virulent than others. 40% of patients with stone culture positive for proteus demonstrated positive qSOFA scores, whereas that rate was 15% or less for all other stone culture species. Interestingly, even in patients with a negative stone culture, 10% of patients met qSOFA criteria. These data may help surgeons, anesthesiologists, and critical care physicians plan supportive care during and after PCNL procedures. Source of Funding: none Boston, MA; Vancouver, Canada; Cleveland, OH; Indiannapolis, IN; San Diego, CA; Columbus, OH; New York City, NY; Scottsdale, AZ; Nashville, TN; Columbus, OH; Indiannapolis, IN; Vancouver, Canada; San Diego, CA; Boston, MA© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e329-e329 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Carlos Mejia Arbelaez* More articles by this author Alan Yaghoubian More articles by this author Timothy Batter More articles by this author Dianne Sacco More articles by this author Ben Chew More articles by this author Manoj Monga More articles by this author Amy Krambeck More articles by this author Roger Sur More articles by this author Bodo Knudsen More articles by this author Nina Mikkilineni More articles by this author Ojas Shah More articles by this author Karen Stern More articles by this author Smita De More articles by this author Nicole Miller More articles by this author Tatevik Broutian More articles by this author Michael Sourial More articles by this author Justin Rose More articles by this author Tim Large More articles by this author Kymora Scotland More articles by this author Colin Lundeen More articles by this author Dirk Lange More articles by this author Thomas DiPina More articles by this author Seth Bechis More articles by this author Brian Eisner More articles by this author Expand All Advertisement PDF downloadLoading ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.017 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".