title: Risk factors for pulmonary complications after percutaneous nephrolithotomy: A retrospective observational analysis.
abstract: Although percutaneous nephrolithotomy is minimally invasive, it is associated with several complications, including extravasation of fluid and urine, the need for a blood transfusion, and septicemia. However, little is known about pulmonary complications after this procedure. Therefore, we aimed to evaluate the risk factors for and outcomes of pulmonary complications after percutaneous nephrolithotomy.All consecutive patients who underwent percutaneous nephrolithotomy between 2001 and 2014 were identified and divided into group A (no clinically significant pulmonary complications) and group B (clinically significant pulmonary complications). Preoperative and intraoperative variables and postoperative outcomes were evaluated. Independent risk factors for postoperative pulmonary complications were evaluated by univariate and multivariate logistic regression analyses.The study included 560 patients: 378 (67.5%) in group A and 182 (32.5%) in group B. Multivariate logistic regression analysis revealed that the independent risk factors for pulmonary complications after percutaneous nephrolithotomy were a higher body mass index (odds ratio = 1.062, P = 0.026), intraoperative red blood cell transfusion (odds ratio = 2.984, P = 0.012), and an intercostal surgical approach (odds ratio = 3.046, P < 0.001). Furthermore, the duration of hospital stay was significantly longer (8.4 ± 4.3 days vs 7.6 ± 3.4 days, P = 0.010) and the intensive care unit admission rate was significantly higher [13 (7.1%) vs 1 (0.3%), P < 0.001] in group B than in group A.Risk factors for pulmonary complications after percutaneous nephrolithotomy were a higher body mass index, intraoperative red blood cell transfusion, and an intercostal surgical approach. Postoperative pulmonary complications were associated with poor outcomes. These results may provide useful information for the perioperative management of pulmonary complications after percutaneous nephrolithotomy.
authors: Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul Department of Anesthesiology and Pain Medicine, Dankook University Hospital, Cheonan-si Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors: Jihion
authors: J
authors: Yu
authors: Jae Moon
authors: JM
authors: Choi
authors: Joonho
authors: J
authors: Lee
authors: Koo
authors: K
authors: Kwon
authors: Yu-Gyeong
authors: YG
authors: Kong
authors: Hyungseok
authors: H
authors: Seo
authors: Jai-Hyun
authors: JH
authors: Hwang
authors: Hyung Keun
authors: HK
authors: Park
authors: Young-Kug
authors: YK
authors: Kim
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003422:Critical Care / Q000706:statistics & numerical data; D017707:Erythrocyte Transfusion; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008171:Lung Diseases / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors