Septic Shock Following Endoscopic Stone Surgery: Incidence, Clinical Characteristics, and Outcomes in a Retrospective Cohort Study

AbstractAim/Objective: To evaluate the incidence, clinical characteristics, microbiological profile, and outcomes of septic shock requiring intensive care unit (ICU) admission following endoscopic stone surgery.Methods: Patients who underwent endoscopic stone surgery between January 2024 and January 2026 were retrospectively reviewed. Cases of septic shock requiring ICU admission within the first 7 postoperative days were identified. Demographic characteristics, comorbidities, perioperative variables, microbiological findings, APACHE II and SOFA scores at ICU admission, and 30-day mortality were analysed.Results: Among 3,702 patients who underwent endoscopic stone surgery, 21 developed septic shock requiring ICU admission, yielding an incidence of 0.57%. The affected patients had a mean age of 67.0 ± 11.9 years, and diabetes mellitus (57.1%) and hypertension (52.4%) were the most common comorbidities. Preoperative and postoperative urine cultures were positive in 61.9% and 71.4% of patients, respectively, with Escherichia coli being the predominant pathogen. The mean APACHE II and SOFA scores at ICU admission were 17.67 ± 6.82 and 7.57 ± 2.13, respectively. Non-invasive respiratory support was required in 23.8% of patients, whereas no patient required invasive mechanical ventilation. Renal replacement therapy and multiple organ dysfunction syndrome each occurred in 19.0% of patients. The 30-day mortality rate was 14.3%.Conclusion: Septic shock following endoscopic stone surgery is an uncommon but clinically significant complication. Although it occurred in only 0.57% of patients, it was associated with substantial organ support requirements and a 30-day mortality rate of 14.3%. Early recognition and intensive care management may help improve outcomes in affected patients.