Systemic inflammatory response syndrome after percutaneous nephrolithotomy: an assessment of risk factors.
OBJECTIVE
To analyze the risk factors for systemic inflammatory response syndrome (SIRS) after percutaneous nephrolithotomy (PCNL) and to quantitatively predict the probability of SIRS after PCNL.


METHODS
Medical records on 209 patients who underwent PCNL were retrospectively analyzed. The chi2 test, the t-test and a logistic regression model were used to identify key risk factors of SIRS after PCNL. A predictive equation was then formulated to assess the risk of SIRS according to the results from the logistic model. Subsequently, the accuracy of the equation by calculating sensitivity, specificity, overall correct percentage, and positive and negative predictive values was tested.


RESULTS
The incidence of SIRS after PCNL was 23.4%. The key risk factors for SIRS following PCNL were: the number of tracts, receipt of a blood transfusion, stone size, and presence of pyelocaliectasis. Other factors added no independent risk to the development of SIRS. The calculated values for sensitivity, specificity, overall percentage correct, positive predictive value and negative predictive value were 44.9%, 95.0%, 83.3%, 73.3%, and 84.9%, respectively.


CONCLUSIONS
Number of tracts, receipt of a blood transfusion, stone size and presence of pyelocaliectasis are identified as the key risk factors for SIRS after PCNL. The predictive equation allows for an individualized and quantitative assessment of the probability of SIRS after PCNL.
Chen
Liang
L
Department of Urology, Peking University People's Hospital, Beijing, China.
Xu
Qing-Quan
QQ
Li
Jian-Xing
JX
Xiong
Liu-Lin
LL
Wang
Xiao-Feng
XF
Huang
Xiao-Bo
XB
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects*; D011237:Predictive Value of Tests; D053018:Pyonephrosis / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology*; D065227:Transfusion Reaction; D014545:Urinary Calculi / Q000150:complications / Q000601:surgery; D055815:Young Adult