Liu Xin,Liu Ge,Yang Yi.Related factors predicting breakthrough febrile urinary tract infection in children with vesicoureteral reflux[J].Journal of Clinical Pediatric Surgery,,22():911-916.[doi:10.3760/cma.j.cn101785-202307033-003]
Related factors predicting breakthrough febrile urinary tract infection in children with vesicoureteral reflux
- Keywords:
- Vesico-Ureteral Reflux; Urinary Tract Infection; Risk Factors; Child
- Abstract:
- Objective To evaluate the feasibility of individual patient-related related factors as the predictive factors for breakthrough febrile urinary tract infection (UTI) in children with vesicoureteral reflux (VUR).Methods For this retrospective study,140 children with primary VUR and detailed data of voiding cystourethrogram (VCUG) were identified from 2018 to 2022.There were 78 boys and 62 girls with a median age of 4 months at initial febrile UTI.Clinical characteristics were collected for identifying the predictors of breakthrough febrile UTI.Univariate and multivariable analyses were performed.Statistical analysis was performed with SPSS version 21.0 software package.Results VUR was bilateral (n=76) and unilateral (n=64).There were advanced VUR (n=65,46.4%) and bladder-bowel dysfunction (n=50,35.7%).And 68 children experinced at least one bout of breakthrough febrile UTI.After a diagnosis of VUR,72 children (51.4%) had no record of UTI during an oral preventive dosing of antibiotics.According to univariate analysis,VUR grade (P=0.001),presence of advanced VUR (P=0.000),ureteral diameter ratio (P=0.000) and presence of bladder-bowel dysfunction (P=0.018) were associated with breakthrough febrile UTI while age,gender,VUR timing on VCUG,presence of bilateral VUR failed to reach significance (P>0.05).Based upon multivariable analysis,presence of advanced VUR[OR=2.942(1.219-7.099)]and ureteral diameter ratio[OR=1313.746(35.720-48318.362)]were among the strongest predictors of breakthrough febrile UTI.Conclusion Advanced VUR and ureteral diameter ratio >0.33 are the strongest predictors of breakthrough febrile UTI in children.
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Memo
收稿日期:2023-7-18。
基金项目:国家自然科学基金青年科学基金项目(81701531)
通讯作者:杨屹,Email:yangy2@sj-hospital.org