Procalcitonin for Early Diagnosis of Urosepsis After Ureteroscopic Lithotripsy: A Retrospective Cohort Study

Objective This retrospective cohort study analyzed the timeliness and clinical significance of procalcitonin (PCT) in the early diagnosis of urosepsis after ureteroscopic lithotripsy for infectious stones. Methods A retrospective analysis was conducted on 279 patients treated at Hangzhou Third People's Hospital from January 2018 to November 2024. 63 patients developed sepsis (observation group), and 216 did not (control group). Infection indicators, including PCT, C-reactive protein (CRP) ,and White blood cell count (WBC), were monitored before surgery and at 2h, 6h, 24h, and 48h postoperatively. Results Baseline indicator levels were comparable between groups pre-surgery. In the observation group, serum PCT increased at 2h post-surgery but did not differ significantly from the control group. At 6h, 24h, and 48h, serum PCT levels were significantly higher in the observation group. Serum CRP and WBC showed no significant changes at 2h and 6h but were significantly higher at 24h and 48h in the observation group. PCT at 6h post-surgery had the highest predictive ability (AUC = 0.89, 95% CI 0.84–0.94), significantly outperforming CRP (AUC = 0.74) and WBC (AUC = 0.68). Conclusion PCT monitoring at 6h postoperatively may serve as a *clinically actionable marker* for early antibiotic initiation.