Time to Decompression in Obstructive Urosepsis from Ureteral Calculi: Thresholds, Initial Diversion, and Early Biomarkers: A Systematic Review.

ABSTRACT: Background/Objectives: Obstructive urosepsis mandates rapid source control, yet actionable time-to-decompression (TTD) thresholds and the influence of diversion route remain debated. This review synthesized evidence on TTD, early outcomes, and predictive biomarkers. Methods: Following PRISMA-2020, ten studies met eligibility: three large administrative cohorts and seven clinical series/trials comparing outcomes by TTD and/or initial decompression (retrograde stent [RUS] vs. percutaneous nephrostomy [PCN]) and reporting biomarkers. Results: Delays were consistently harmful. In a national cohort, a TTD of ≥ 2 days increased in-hospital mortality (adjusted OR, 1.29; 95% CI, 1.03-1.63). Another analysis showed mortality of 0.16% with ≤48 h vs. 0.47% when delayed (derived O

SUBMITTER: Benea A 

PROVIDER: S-EPMC12693273 | biostudies-literature | 2025 Dec

REPOSITORIES: biostudies-literature