Objective: This study aims to evaluate the clinical outcomes of patients receiving antithrombotic (antiaggregant and anticoagulant) therapy who underwent emergency percutaneous nephrostomy (PN) for the treatment of receiving complicated upper urinary tract infection.
Material and Methods: Data of consecutive patients who underwent emergency PN from January 2014 to October 2024 were retrospectively reviewed. A total of 34 patients on antithrombotic treatment (Group 1) and 35 control group patients (Group 2) without bleeding disorders or any antithrombotic treatment were included. Demographics, indications for PN, pre- and post-procedural hematological, biochemical, and microbiological parameters and complications were analyzed.
Results: The mean age was 68.65±1.49 in group 1 and 62.09±1.77 in group 2 (p = 0.006). Sex distribution and indications for PN were comparable between groups. There was no significant difference in emergency PN indications, grade of hydronephrosis, and PN placement sides. The most common antithrombotic agent in group 1 was warfarin (44.1 %). Escherichia coli was the most common bacteria isolated in both groups (55.9% vs. 48.6 % for groups 1 and 2, respectively). No major complications were observed in either group. Blood replacement was performed in 4 and 3 patients in groups 1 and 2, respectively. Mean post-procedure Hg levels were similar in both groups (9.53 ±1.39 vs. 9.98 ±1.18 for groups 1 and 2, respectively). No difference in median hospital stay was observed between the groups.
Conclusion: Antithrombotic drugs pose a potential bleeding risk during PN placement. This is the first study in the literature on PN placement in patients on antithrombotic therapy, and it shows that the procedure can be performed with low complication rates in patients on antithrombotic therapy.
Abstract
Objective: This study aims to evaluate the clinical outcomes of patients receiving antithrombotic (antiaggregant and anticoagulant) therapy who underwent emergency percutaneous nephrostomy (PN) for the treatment of receiving complicated upper urinary tract infection.
Material and Methods: Data of consecutive patients who underwent emergency PN from January 2014 to October 2024 were retrospectively reviewed. A total of 34 patients on antithrombotic treatment (Group 1) and 35 control group patients (Group 2) without bleeding disorders or any antithrombotic treatment were included. Demographics, indications for PN, pre- and post-procedural hematological, biochemical, and microbiological parameters and complications were analyzed.
Results: The mean age was 68.65±1.49 in group 1 and 62.09±1.77 in group 2 (p = 0.006). Sex distribution and indications for PN were comparable between groups. There was no significant difference in emergency PN indications, grade of hydronephrosis, and PN placement sides. The most common antithrombotic agent in group 1 was warfarin (44.1 %). Escherichia coli was the most common bacteria isolated in both groups (55.9% vs. 48.6 % for groups 1 and 2, respectively). No major complications were observed in either group. Blood replacement was performed in 4 and 3 patients in groups 1 and 2, respectively. Mean post-procedure Hg levels were similar in both groups (9.53 ±1.39 vs. 9.98 ±1.18 for groups 1 and 2, respectively). No difference in median hospital stay was observed between the groups.
Conclusion: Antithrombotic drugs pose a potential bleeding risk during PN placement. This is the first study in the literature on PN placement in patients on antithrombotic therapy, and it shows that the procedure can be performed with low complication rates in patients on antithrombotic therapy.