Multivariate analysis of factors for failed continuous bladder irrigation in hemorrhagic cystitis patients after hematop
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RESEARCH ARTICLE
Open Access
Multivariate analysis of factors for failed continuous bladder irrigation in hemorrhagic cystitis patients after hematopoietic stem cell transplantation Wenbo Yang†, Yiqing Du†, Zhan Qu, Wenjun Bai, Luping Yu, Xiaopeng Zhang, Qi Wang, Xiaowei Zhang, Qing Li and Tao Xu*
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 8.89 ng/ml (RR = 7.828, 95% CI 2.885–21.244), age 37d after transplantation (RR = 7.021, 95% CI 2.204–22.364), were independent risk factors for failure of CBI (P 8.89 ng/ml, age 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. Keywords: Continuous saline bladder irrigation, Transplant-related adverse events, Hemorrhagic cystitis, C-reactive protein, Hematopoietic stem cell transplantation, CRP
*Correspondence: [email protected] † Wenbo Yang and Yiqing Du have contributed equally to this work Department of Urology, Peking University People’s Hospital, 11 South Xizhimen Street, Beijing 100044, China
Background Hemorrhagic cystitis (HC) after allogeneic hematopoietic stem cell transplantation (HSCT) is characterized by diffuse inflammation and hemorrhage of the bladder mucosa. Its clinical manifestation, severity, and prognosis vary greatly. It has been reported that the incidence of HC, as one of the major complications in allogeneic
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