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Yang W, Du Y, Qu Z, Bai W, Yu L, Zhang X, Wang Q, Zhang X, Li Q, Xu T. Multivariate analysis of factors for failed continuous bladder irrigation in hemorrhagic cystitis patients after hematopoietic stem cell transplantation. BMC Urol 2020; 20:184. [PMID: 33172460 PMCID: PMC7653991 DOI: 10.1186/s12894-020-00757-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 11/02/2020] [Indexed: 01/19/2023] Open
Abstract
Background Continuous bladder irrigation (CBI) and proper adjustment of saline irrigation speed are important to avoid CBI failure in hemorrhagic cystitis (HC) patients after allogeneic hematopoietic stem cell transplantation (HSCT). Nevertheless, too fast irrigation speed could take away the patient's much heat, contribute to blood coagulopathy, and increase the nursing workload. Evaluation of risk for CBI failure remains an unmet clinical need. Methods The general information, clinical characteristics, and consultation records of HC patients in 1380 patients with hematopoietic stem cell transplantation in our center from 2017 to 2019 were analyzed retrospectively. The receiver operating characteristic (ROC) curve was used to calculate the cutoff point of the continuous variable, and multivariate logistic regression was used to analyze the risk factors affecting CBI failure in HC patients. Results The incidence of HC after HSCT was 23%. A total of 227 patients with HC above grade 2 were included. Univariate analysis showed that CRP, age, platelet counts, onset time after transplantation, albumin, and hemoglobin were associated with CBI failure in the short-term (P < 0.05). ROC curve and multivariate logistic regression analysis showed that CRP > 8.89 ng/ml (RR = 7.828, 95% CI 2.885–21.244), age < 14.5 years (RR = 9.940, 95% CI 3.219–30.697), and onset time of HC > 37d after transplantation (RR = 7.021, 95% CI 2.204–22.364), were independent risk factors for failure of CBI (P < 0.05). Conclusions The study identified CRP > 8.89 ng/ml, age < 14.5 years, and onset time of HC after HSCT > 37d are independent factors for failure of CBI, which could be combined to allow stratification of HC after HSCT patients into low-, intermediate- and high-risk subgroups of CBI failure.
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Affiliation(s)
- Wenbo Yang
- Department of Urology, Peking University People's Hospital, 11 South Xizhimen Street, Beijing, 100044, China
| | - Yiqing Du
- Department of Urology, Peking University People's Hospital, 11 South Xizhimen Street, Beijing, 100044, China
| | - Zhan Qu
- Department of Urology, Peking University People's Hospital, 11 South Xizhimen Street, Beijing, 100044, China
| | - Wenjun Bai
- Department of Urology, Peking University People's Hospital, 11 South Xizhimen Street, Beijing, 100044, China
| | - Luping Yu
- Department of Urology, Peking University People's Hospital, 11 South Xizhimen Street, Beijing, 100044, China
| | - Xiaopeng Zhang
- Department of Urology, Peking University People's Hospital, 11 South Xizhimen Street, Beijing, 100044, China
| | - Qi Wang
- Department of Urology, Peking University People's Hospital, 11 South Xizhimen Street, Beijing, 100044, China
| | - Xiaowei Zhang
- Department of Urology, Peking University People's Hospital, 11 South Xizhimen Street, Beijing, 100044, China
| | - Qing Li
- Department of Urology, Peking University People's Hospital, 11 South Xizhimen Street, Beijing, 100044, China
| | - Tao Xu
- Department of Urology, Peking University People's Hospital, 11 South Xizhimen Street, Beijing, 100044, China.
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