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

Abstract

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.

The global, prevalence, and risk factors of postoperative fever after percutaneous nephrolithotomy: A systematic review and meta-analysis

“…The current study showed that diabetes was able to increase postoperative fever in PCNL patients (OR: 4.62; 95% CI: 2.95–7.26). In agreement with the study, several studies have confirmed the impact of diabetes in postoperative fever development [ 3 , 10 , 26 ]. Patients who have suffered from long-term diabetes might result in reduced blood flow to their extremities, which increase the risks of infection.…”

“…The results showed that patients who suffered from hydronephrosis were more likely to develop postoperative fever. Studies have shown that hydronephrosis could be correlated with postoperative fever after PCNL [ 26 ]. Li et al.…”

“…Of course, postoperative fever after PCNL may be correlated with a degree of hydronephrosis (mild, moderate, or severe). This study indicated the degree of hydronephrosis is a risk factor for postoperative fever after PCNL [ 9 , 25 ].…”

“…In addition, factors such as positive preoperative urine culture, female gender, duration of operation, nephrostomy tube use, diabetes mellitus, chiropractic, type of stone, and history of PCNL surgery may increase the risk of fever [ [5] , [6] , [7] , [8] ]. However, studies not only have shown that diabetes mellitus patients are at higher risk of developing postoperative fever, but also have shown significant differences between the number of diabetes mellitus patients with and without postoperative fever [ 3 , 9 ]. It seems that another risk factor of postoperative fever after PCNL might be hydronephrosis, but there is controversial information about its effects on postoperative fever in patients who had undergone PCNL.…”

Is hydronephrosis a risk factor for complications in conventional percutaneous nephrolithotomy?

“…10 According to studies success rate of PCNL is more than 90% and postoperative bleeding is its common and serious complication which most of the times can be treated conservatively while sometimes (in 0.8% cases) arteriography and selective embolization is required. 11,12 A study conducted in Korea by Kim et al reported that patients without hydronephrosis undergoing PCNL required longer hospital stay, prolonged operating time, lower stone clearance rate and higher blood transfusion rate due to bleeding complications as compared to the patients with hydronephrosis. 13 In our study, postoperative bleeding was observed in 64 (40.7%) patients who had hydronephrosis in contrast to 82 (57.3%) patients who had not had hydronephrosis, and the p-value was 0.004.…”