Blood Parameters as a Predictor of Fever After Percutaneous Nephrolithotomy

TC Erciyes University

Status: Completed

Conditions: Urinary Tract Infection Bacterial; Nephrolithiasis

Treatments: Diagnostic Test: peripheric blood count

Study type: Interventional

Funder types: Other

Identifiers

NCT03774940

2013/198

Details and patient eligibility

About

To investigate the relationship between neutrophil count, lymphocyte count, neutrophil-to-lymphocyte count ratio (NLR), and postoperative fever in patients undergoing percutaneous nephrolithotomy (PNL).

Full 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.

Enrollment: 519 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

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
• a preoperative urinary diversion and/or intervention
• 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

Trial design

Primary purpose: Prevention

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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519 participants in 2 patient groups

fever

Experimental group

Description:

patients that have fever after PNL

Treatment:

Diagnostic Test: peripheric blood count

No fever

Active Comparator group

Description:

Patients without fever after PNL

Treatment:

Diagnostic Test: peripheric blood count