## 4 Discussion  
Of the 31.5 million sepsis cases and 5.3 million deaths due to sepsis reported globally each year [13], approximately 15.9% of sepsis cases have a urinary source [14]. A total of 78% of urosepsis cases are associated with obstructive uropathy and 43% of obstructive uropathy cases are caused by urinary stones [4]. Surgical decompression is the most important factor in patients with obstructive urosepsis and which necessitates urgent decompression due to \begin{table}
\begin{tabular}{l r r r} \hline \hline \multicolumn{1}{c}{**Predictors**} & \multicolumn{1}{c}{**Non-sepsis/APN**} & \multicolumn{1}{c}{**Sepsis/APN**} & \multicolumn{1}{c}{\(p\)} \\ \hline No. pts & 51,494 & 25,747 & \\ Mean \(\pm\) SD age & 56.8 \(\pm\) 17.7 & 56.8 \(\pm\) 17.7 & 1 \\ No. gender (\%) & 33,249 (64.57) & 8462 (32.87) & \textless{}0.0001 \\ Female & 18,245 (35.43) & 17,285 (67.13) & \\ No. race (\%) & & & \\ White & 35,519 (68.98) & 16,531 (64.21) & \\ Hispanic & 3836 (7.45) & 2480 (9.63) & \\ Black & 3313 (6.43) & 2155 (8.37) & \\ Asian & 1106 (2.15) & 491 (1.91) & \\ Unknown & 7720 (14.99) & 4090 (15.89) & \\ No. underlying disease (\%) & & & \\ Ischemic heart diseases & 9012 (17.5) & 6088 (23.65) & \textless{}0.0001 \\ Hypertension & 24,843 (48.24) & 15,112 (88.69) & \textless{}0.0001 \\ Diabetes mellitus & 11,298 (21.94) & 8675 (33.69) & \textless{}0.0001 \\ Stroke & 5330 (10.35) & 4602 (17.87) & \textless{}0.0001 \\ [PERSON]’s disease & 476 (0.92) & 502 (1.95) & \textless{}0.0001 \\ Chronic kidney disease & 3091 (6) & 3290 (12.78) & \textless{}0.0001 \\ Chronic respiratory disease & 10,185 (19.78) & 8007 (31.1) & \textless{}0.0001 \\ Obesity & 6699 (31.01) & 5777 (22.44) & \textless{}0.0001 \\ Cancer & 20,541 (39.89) & 11,513 (44.72) & \textless{}0.0001 \\ No. medical history (\%) & & & \\ History of UTI & 2601 (5.05) & 11,554 (44.88) & \textless{}0.0001 \\ History of urinary stones & 15,630 (30.35) & 10,328 (40.11) & \textless{}0.0001 \\ Total cost (\$) & & & \\ Stent insertion, median (IQR) & 376 (126-2111) & 274 (237–1446) & 0.1388 \\ Nephrostomy, median (IQR) & 1027 (669–2423) & 952 (669–1748) & 0.1910 \\ \hline \hline \end{tabular}
\end{table} 
Table 2: Age-matched univariate analysis of the patients with ureteral calculi. \begin{table}
\begin{tabular}{l r r} \hline \hline \multicolumn{1}{c}{**Predictors**} & \multicolumn{1}{c}{**OR (95\% CI)**} & \multicolumn{1}{c}{\(p\)} \\ \hline History of UTI & 11.31 (10.68–11.99) & \textless{}0.0001 \\ Female gender & 2.73 (2.62–2.84) & \textless{}0.0001 \\ Race & Reference & - \\ White & 1.28 (1.19–1.37) & -0.0001 \\ Hispanic & 1.19 (1.10–1.28) & \textless{}0.0001 \\ Black & 1.11 (0.97–1.27) & 0.1496 \\ Asian & 0.94 (0.90–0.98) & 0.0042 \\ Cancer & 0.91 (0.87–0.95) & \textless{}0.0001 \\ Urinary Stone history & 0.91 (0.87–0.95) & \textless{}0.0001 \\ Sum of comorbidity * & Reference & \\
1 & 1.23 (1.16–1.30) & \textless{}0.0001 \\
2 & 1.65 (1.55–1.76) & \textless{}0.0001 \\ \(\geq\)3 & 3.00 (2.82–3.18) & \textless{}0.0001 \\ \(\geq\)3 & 11.31 (10.68–11.99) & \textless{}0.0001 \\ Alzheimer’s disease & 1.75 (149–20.6) & \textless{}0.0001 \\ Chronic kidney disease & 1.73 (1.61–1.86) & \textless{}0.0001 \\ Stroke & 1.50 (1.41–1.6) & \textless{}0.0001 \\ Diabetes mellitus & 1.46 (1.39–1.53) & \textless{}0.0001 \\ Chronic respiratory diseases & 1.32 (1.26–1.38) & \textless{}0.0001 \\ Ischemic heart diseases & 1.24 (1.17–1.31) & \textless{}0.0001 \\ Obesity & 1.23 (1.16–1.29) & \textless{}0.0001 \\ Hypertension & 1.22 (1.16–1.28) & \textless{}0.0001 \\ \hline \hline \end{tabular}  
* sum of Alzheimer, chronic kidney disease, stroke, diabetes, chronic respiratory diseases, ischemic heart diseases, overweight, and hypertension. APN = acute pylonephritis; IQR = interquartile range; SD = standard deviation; UTI = urinary tract infection.  
\end{table} 
Table 3: Multivariate analysis of the patients with ureteral calculi. the attendant high mortality rate. [PERSON] et al.