Retrospective Evaluation of Preoperative Blood Inflammation Biomarkers for Predicting Post-PCNL SIRS

Abstract

Abstract Objective: The aim of the study was to evaluate the predictive value of preoperative inflammation indicators in systemic inflammatory response syndrome (SIRS) after percutaneous nephrolithotomy (PCNL). Materials and Methods: A retrospective analysis was conducted on 222 patients who underwent PCNL at our institution between January 2018 and December 2022. The primary endpoint was the development of SIRS after PCNL. Univariate and multivariate regression analyses were used to identify the independent factors associated with SIRS post-PCNL. Receiver operating characteristic (ROC) curves were generated and the areas under the curve (AUC) were calculated. Results: Among the 222 patients who underwent PCNL, 56 patients (25.2%) developed SIRS. Multivariate analysis revealed that serum leukocyte (OR 1.751; 95% CI 1.304-2.352; p ＜0.001), stone size (OR 2.589; 95% CI 1.164-5.756; p = 0.02), and positive urine culture (OR 5.905; 95% CI 2.397-14.548; p ＜0.001) were independent predictors of post-PCNL SIRS. The optimal cutoff value of serum leukocyte was 6.39×109/L through ROC analysis. In addition, there was no statistically significant correlation between preoperative neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), prognostic nutritional index (PNI), systemic inflammation response index (SIRI), systemic immune-inflammation index (SII) and the incidence of postoperative SIRS. Conclusion: Results demonstrate that stone size, preoperative serum leukocyte count, and urine culture are significant predictors of the development of SIRS following PCNL, and could therefore serve as useful predictors in clinical practice. Conversely, no significant association between other clinical inflammation biomarkers and the occurrence of post-PCNL SIRS was observed.