Risk Factors for Postoperative Systemic Inflammatory Response Syndrome Following Minimally Invasive Percutaneous Nephrolithotomy
To analyze the risk factors that affect systemic inflammatory response syndrome (SIRS) following minimally invasive percutaneous nephrolithotomy (MPCNL) for upper urinary tract calculus.
We retrospectively analyzed the clinical data from consecutive cases of upper urinary calculi treated by one-phase MPCNL between January 2012 and December 2016. The patients were divided into two groups as patients developing SIRS or not. The clinical data before and during operations were compared between the patients with or without SIRS. By a logistic regression model, univariate and multivariate statistical analyses were performed to determine factors affecting the development of postoperative SIRS.
The MPCNL procedures of 173 cases were successful, and the incidence of SIRS after MPCNL was 15.0% (26/173). Compared with non-SIRS group, SIRS group had higher mean stone burden (409.3±49.3 mm2 vs. 370.7±77.7 mm2, P = 0.015) and higher mean irrigation rate (206.4±33.7 ml/min vs. 182.6±34.9 ml/min, P = 0.002). The rate of postoperative SIRS in patients with diabetes mellitus was 30.0% (9/30), higher than that (11.9%, 17/143) in patients without diabetes mellitus (P = 0.012). Multivariable logistic regression analysis identified diabetes mellitus history (OR = 2.998?P = 0.045), stone burden ? 400 mm2 (OR = 3.038?P = 0.030), irrigation rate ? 200 ml/min (OR = 4.969?P = 0.001) as independent risk factors for SIRS following MPCNL.
Diabetes mellitus history, higher stone burden, increased irrigation rate are independent risk factors to predict SIRS following one-phase MPCNL for upper urinary tract calculus.