Is the Preoperative Level of Procalcitonin a Valid Indicator for Predicting Postoperative Fever After Percutaneous Nephrolithotomy?

Deng, Li; M, Sha; Chen, Lei; Xiao, Yinglong; Zhuo, Jian; Lü, Jun; Shao, Yi

doi:10.1089/end.2017.0761

Cited by 11 publications

(10 citation statements)

References 27 publications

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“…Besides, for patients with hydronephrosis before surgery, sometimes due to urinary tract obstruction is more serious, after antibiotic treatment, urinary leukopenia. And there may be an illusion that preoperative infection is basically controlled, but the renal pelvis fluid is still turbid and even purulent, and the bacteria in the stones still remain (3,16). Therefore, we believe that patients with preoperative urinary tract infection should be given sufficient attentions, adequate active treatment with sensitive antibiotics to reduce postoperative infection are needed.…”

Section: Discussionmentioning

confidence: 99%

“…As a common urological disease, the incidence of urinary tract calculi has significantly increased in recent years, if left untreated, it can severely impair the function of urinary system (1,2). Percutaneous nephrolithotomy (PCNL) has gradually become the preferred choice for the treatment of urinary calculi clinically, and its safety and efficacy have been recognized by patients and clinician (3). However, PCNL can complicate many adverse events.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for the fever after percutaneous nephrolithotomy: a retrospective analysis

et al. 2020

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Background: It's very common to see the onset of fever after percutaneous nephrolithotomy (PCNL), it's necessary to analyze the risk factors for the fever following PCNL, and to provide evidence for infection prevention after PCNL.Methods: A total of 546 adult PCNL patients were included as study subjects and retrospective studies were performed. We collected clinical data of patients using a prospectively designed database. Univariate and multivariate logistic regression analyses were performed to identify the potential risk factors for the fever after PCNL.Results: Of the included 546 PCNL patients, there were 82 fever patients and 464 no-fever patients following PCNL. Escherichia coli and Proteus mirabilis are the two most common infectious bacteria.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk factors for the fever after percutaneous nephrolithotomy: a retrospective analysis

et al. 2020

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“…Some studies have shown that positive UC was the independent risk factor for postoperative infectious complications [2]. Procalcitonin (PCT) is a biomarker for the diagnosis of sepsis and prognosis of bacterial infections whose high levels appeared strongly correlated with systemic bacterial infections [3,4]. However, many clinicians believe that serum PCT is not sufficiently specific or sensitive to GP bacteria and some studies reported that PCT is higher in Gramnegative bacteremia than Gram-positive bacteremia and fungemia [5,6].…”

Section: Introductionmentioning

confidence: 99%

The value of procalcitonin for predicting urosepsis after mini-percutaneous nephrolithotomy or flexible ureteroscopy based on different organisms

et al. 2021

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Purpose To assess the value of procalcitonin (PCT) as an early biomarker for predicting urosepsis caused by Gram-negative (GN) bacteria, Gram-positive (GP) bacteria and fungi following mini-percutaneous nephrolithotomy (mPCNL) and flexible ureteroscopy (FURS). Methods A total number of 356 patients with positive preoperative UC (urine cultures) who underwent mPCNL and FURS between June 2017 and January 2021 were retrospectively analyzed. Univariable analysis and multivariable logistic regression analysis were conducted to compare the predictors for urosepsis caused by different organisms. Furthermore, the nomogram was established as a predicted model for urosepsis. Results Among 356 positive UC, 265 (74.4%) were positive for GN bacteria, 77 (21.4%) for GP bacteria and 14 (3.9%) for fungal pathogens. Escherichia coli (48.9%) were the predominant pathogens and Enterococcus (54/77) were the most common GP bacteria. Multivariate logistic regression analysis showed that positive nitrite (OR 3.31, 95% CI 1.20-9.14; P = 0.021), operative time > 90 min (OR 3.10, 95% CI 1.10-8.75, P = 0.033) and postoperative PCT > 0.1 ng/mL (OR 56.18, 95% CI 15.20-207.64, P < 0.001) were associated with postoperative urosepsis originated in GN infections, while urosepsis caused by GP bacteria and fungi was not associated with PCT > 0.1 ng/mL (P = 0.198), only stone burden > 800 mm 2 (OR 3.69, 95% CI 1.01-13.53, P = 0.049) was an independent risk factor. Conclusions For patients with positive preoperative UC, postoperative PCT > 0.1 ng/mL was an independent risk factor of post-PCNL and post-FURS urosepsis caused by GN bacteria rather than GP bacteria and fungi.

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“…The present study has found that the postoperative serum levels of IL-6 was significantly lower in patients with urosepsis of the EXP group in comparison with those in the CON group, which represented an alleviated severity of infection and inflammation. PCT, as a 116-amino acid polypeptide, is secreted from neutrophils and parenchymal cells when bacterial infections occur and is a valuable biomarker for early diagnosis of systemic infection, especially for sepsis, and PCT can be up-regulated by bacterial endotoxins and proinflammatory mediators such as IL-6 and tumor necrosis factors and will be down-regulated when infection is controlled, and the concentrations of endotoxins and proinflammatory mediators decreas [28][29][30][31]. The value of PCT can represent the severity of infection.…”

Section: Discussionmentioning

confidence: 99%

The retrospective study of perioperative application of dexamethasone and furosemide for postoperative anti-inflammation in patients undergoing percutaneous nephrolithotomy

Xia

Chen

et al. 2021

Int Urol Nephrol

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Objectives To investigate whether the perioperatively combined application of dexamethasone and furosemide could alleviate the inflammation in patients undergoing percutaneous nephrolithotomy (PCNL). Patients and methods 147 patients undergoing PCNL between November 2018 and October 2019 were enrolled in the study. 77 patients accepted a single dose of dexamethasone and furosemide administration (EXP group, n = 77), and 70 patients did not (CON group, n = 70). Demographic and perioperative data, inflammatory markers including interleukin-6 (IL-6) and procalcitonin (PCT), and clinical outcomes were compared between the two groups. Results Compared with the CON group, the incidence rate of urosepsis of the EXP group were significantly lower (11.69% vs. 24.29%, p = 0.046). 3 patients developed severe urosepsis in the EXP group, while 5 patients developed severe urosepsis in the CON group. Compared with those in the CON group, the patients with postoperative urosepsis in the EXP group showed lower serum levels of IL-6 at postoperative hour two (p = 0.045) and at postoperative day one (p = 0.031) and lower serum levels of PCT at postoperative day one (p = 0.015). There was a better clinical outcome of a shorter postoperative hospital stay (p = 0.015) in patients with postoperative urosepsis in the EXP group than in those in the CON group. Conclusion The perioperatively combined application of dexamethasone and furosemide was beneficial for alleviating postoperative inflammatory reaction and caused a better clinical outcome of a shorter postoperative hospital stay.

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Is the Preoperative Level of Procalcitonin a Valid Indicator for Predicting Postoperative Fever After Percutaneous Nephrolithotomy?

Abstract: We concluded that patients with preoperative fever, stone burden >353 mm, PCT >0.05 ng/mL, or positive urine culture were more likely to develop postoperative fever and that routinely detecting PCT levels before PNL would be helpful in predicting postoperative fever.

Cited by 11 publications

References 27 publications

Risk factors for the fever after percutaneous nephrolithotomy: a retrospective analysis

Risk factors for the fever after percutaneous nephrolithotomy: a retrospective analysis

The value of procalcitonin for predicting urosepsis after mini-percutaneous nephrolithotomy or flexible ureteroscopy based on different organisms

The retrospective study of perioperative application of dexamethasone and furosemide for postoperative anti-inflammation in patients undergoing percutaneous nephrolithotomy

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