Risk factors for systemic inflammatory response syndrome in patients with negative preoperative urine culture after percutaneous nephrolithotomy

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AKDENİZ E., Ozturk K., Ulu M. B., Gur M., Caliskan S. T., Sehmen E.

Journal of the College of Physicians and Surgeons Pakistan, cilt.31, sa.4, ss.410-416, 2021 (SCI-Expanded, Scopus) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 31 Sayı: 4
  • Basım Tarihi: 2021
  • Doi Numarası: 10.29271/jcpsp.2021.04.410
  • Dergi Adı: Journal of the College of Physicians and Surgeons Pakistan
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database
  • Sayfa Sayıları: ss.410-416
  • Anahtar Kelimeler: C-reactive protein, Percutaneous nephrolithotomy, Platelet/lymphocyte ratio, Systemic inflammatory response syndrome
  • Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
  • Samsun Üniversitesi Adresli: Hayır

Özet

Objective: To explore the risk factors for systemic inflammatory response syndrome (SIRS) after percutaneous nephrolithotomy (PCNL) in patients with preoperative negative urine culture (UC). Study Design: Observational study. Place and Duration of Study: Department of Urology, Gazi Hospital, Samsun, Turkey, from January 2015 to January 2020. Methodology: Two hundred and twenty-eight patients, who underwent conventional PCNL for renal stones, were evaluated. The patients were divided into non-SIRS (Group 1) and SIRS (Group 2) groups, and the effects of the variables were investigated to predict the development of SIRS. Results: Despite preoperative sterile UC, SIRS developed postoperatively in 29 (12.7%) patients. The univariate analysis revealed a statistically significant difference between groups in preoperative serum C-reactive protein (CRP) (p <0.001), platelet-to-lymphocyte ratio (PLR) (p <0.001), neutrophil-to-lymphocyte ratio (p = 0.001), urine white blood cell (p = 0.034), stone size (p = 0.023), operative time (p = 0.041), hemoglobin drop (p <0.001), blood transfusion (p = 0.002), hospital stay (p = 0.006), and complication rate (p = 0.001). Receiver operating characteristic analysis indicated that PLR >117.36 (p <0.001), CRP >3.16 mg/L (p <0.001), stone burden >471 mm2 (p = 0.023) and hemoglobin drop >2.3 g/L (p <0.001) are independent risk factors for post-operative SIRS after PCNL. Conclusion: PLR, CRP, stone size, and hemoglobin drop can predict SIRS after PCNL. This finding may help classify risk in patients before PCNL, especially in those with a sterile urine culture.