Blood Parameters as a Predictor of Fever After Percutaneous Nephrolithotomy
Study Details
Study Description
Brief Summary
To investigate the relationship between neutrophil count, lymphocyte count, neutrophil-to-lymphocyte count ratio (NLR), and postoperative fever in patients undergoing percutaneous nephrolithotomy (PNL).
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
Percutaneous nephrolithotomy (PNL) is a minimally invasive treatment commonly used for renal calculi. However, the prevalence of postoperative fever is reported to be 16.7%-35%, even with appropriate prophylactic antibiotic therapy and a sterile urine culture. The most probable causes are urinary extravasation and bacteremia. Although it is important to postoperatively isolate the causative bacteria, bacterial isolation may not always be possible, and urinary and blood cultures may prove negative. In addition, establishing the etiology of fever could be time-consuming and the techniques involved may generate pseudo-negative results owing to several factors, especially the antibiotics used prophylactically. This can result in a prolonged hospital stay and increased the cost of patient care.
The most commonly used parameters for the early diagnosis of bacterial infections, despite their limited use, are C-reactive protein, white blood cell count, and neutrophil count . Superior parameters include procalcitonin, pro-adrenomedullin, interleukin (IL)-6, and IL-8, but their use is limited by their lack of availability in some centers and their higher costs. Recently, the ratio of neutrophil count to lymphocyte count (NLR) has been proposed as an effective, simple, and useful biomarker for the early diagnosis of bacterial infections. However, these tests are used after the emergence of fever. As yet, no single parameter has been proposed for predicting postoperative fever in the absence of preoperative factors known to cause fever.
The aim of this study was to investigate whether neutrophil count, lymphocyte count, and NLR obtained from routine preoperative blood tests could be used in predicting fever following PNL in patients with no risk factors for infection.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: fever patients that have fever after PNL |
Diagnostic Test: peripheric blood count
preoperative peripheric blood count
|
| Active Comparator: No fever Patients without fever after PNL |
Diagnostic Test: peripheric blood count
preoperative peripheric blood count
|
Outcome Measures
Primary Outcome Measures
- White blood cell count [preoperative]
white blood cell count
- Neutrophil count [preoperative]
neutrophil count
- N/L [preoperative]
ratio of neutrophil count to lymphocyte count
- Lymphocyte count [preoperative]
Lymphocyte count
Eligibility Criteria
Criteria
Inclusion Criteria:
-
underwent PNL operation
-
preoperative white blood cell count between 4,000 and 12,000/µL
Exclusion Criteria:
-
preoperative urinary system obstruction
-
proliferation in preoperative and/or postoperative urine culture
-
preoperative and/or postoperative blood transfusions
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a preoperative urinary diversion and/or intervention
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the presence of a postoperative residual stone
-
the presence of malignancy,
-
the presence of a hematologic disease.
-
patients with postoperative complications graded as Clavien 2 and above
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Erciyes University Faculty of Medicine Department of Urology | Kayseri | Turkey | 38039 |
Sponsors and Collaborators
- TC Erciyes University
Investigators
- Principal Investigator: Abdullah Demirtas, MD, Erciyes University Faculty of Medicine
Study Documents (Full-Text)
None provided.More Information
Publications
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