Significance of preoperative neutrophil–lymphocyte count ratio on predicting postoperative sepsis after percutaneous nephrolithotomy

Abstract

We evaluated the usefulness of preoperative neutrophil-lymphocyte count ratio (NLCR) in predicting postoperative sepsis after percutaneous nephrolithotomy (PCNL). In total, 487 patients who underwent PCNL for renal stones were included in the present retrospective study. The stone burden, number of tracts and location, operation time, fluoroscopy time, presence of residual stones, and blood transfusion rates were postoperatively recorded in all patients. All patients were followed up for signs of systemic inflammatory response syndrome (SIRS) and sepsis. The association of sepsis/SIRS with the risk factors of infectious complications, including NLCR, was evaluated. SIRS was detected in 91 (18.7%) patients, 25 (5.1%) of whom were diagnosed with sepsis. Stone burden, operation time, irrigation rate, previous surgery, nephrostomy time, access number, blood transfusion, residual stone, postoperative urinary culture, renal pelvis urinary culture, and stone culture were found to be predictive factors for SIRS and sepsis development. Receiver operating characteristic curve analysis revealed an NLCR cutoff of 2.50 for predicting the occurrence of SIRS/sepsis. We found that the incidence of sepsis was significantly higher in patients with NLCR ≥ 2.50 than in patients with NLCR < 2.50 (p = 0.006). Preoperative and postoperative urine culture positivity were associated with high NLCR (p = 0.039 and p = 0.003, respectively). We believe that preoperative NLCR may be a promising additive predictor of bacteremia and postoperative sepsis in patients who undergo PCNL for renal stones. This marker is simple, easily measured, and easy to use in daily practice without extra costs.

Establishment of a Predictive Model for Factors Related to Systemic Inflammatory Response Syndrome (SIRS) after Percutaneous Nephrolithotomy (PCNL)

“…A total of 30.1% of patients developed SIRS, and no patients developed sepsis. Current studies have shown that the incidence of SIRS after PCNL is between 10% and 30% (6,14). This value was similar to the results in the literature (15, 16) but higher than those in the studies of Wang A]QL (12.5%) and Singh P (17.5%) (3,9).…”

Can Neutrophil Count, Lymhocyte Count and Neutrophil-tolymphocyte Ratio Predict Fever Following Percutaneous Nephrolithotomy in Patients Without Risk Factors?

“…According to the results of our study, 97% of patients without postoperative fever can be estimated by considering NLR and lymphocyte count. We think that postoperative fever and bacteremia can be prevented by various antibiotic prophylaxis strategies and therapeutic (22) demonstrated that the NLR after post-PCNL septicemia was an independent factor in multivariate analysis with a threshold value which is close to the one in our study (>2.5). We think that the reason as to why the NLR value in our study was not significant in the multivariate analysis was the varying number of patients in the two groups (469 vs 50).…”

“…Sonuç: PNL yapılan hastalarda ateş oluşturabilecek risk faktörleri dışladığında lenfosit sayısı ve NLO postoperatif ateşi öngörmede kullanılabilecek kolay ve ucuz bir tanı aracı olarak gözükmektedir. Anahtar Kelimeler: Bakteriyemi, Ateş, PNL, Nötrofil-lenfosit oranı Journal of Urological Surgery, 2020;7(1): [21][22][23][24][25][26] was used to compare non-parametric variables. A p value of less than 0.05 was considered statistically significant.…”

Fever and systemic inflammatory response syndrome after retrograde intrarenal surgery: Risk factors and predictive model

“…CRP was measured using the BCG dye‐binding method and a turbidimetric assay; the normal range at our institution was 0–10 mg/L. The stone burden was calculated by multiplying the longest diameter by the perpendicular diameter of the stone, and the sum of each stone as the total stone burden in cases of multiple stones [8].…”