Risk factors for the fever after percutaneous nephrolithotomy: a retrospective analysis

Transl Androl Urol. 2020 Jun;9(3):1262-1269. doi: 10.21037/tau.2020.03.37.

Abstract

Background: It's very common to see the onset of fever after percutaneous nephrolithotomy (PCNL), it's necessary to analyze the risk factors for the fever following PCNL, and to provide evidence for infection prevention after PCNL.

Methods: A total of 546 adult PCNL patients were included as study subjects and retrospective studies were performed. We collected clinical data of patients using a prospectively designed database. Univariate and multivariate logistic regression analyses were performed to identify the potential risk factors for the fever after PCNL.

Results: Of the included 546 PCNL patients, there were 82 fever patients and 464 no-fever patients following PCNL. Escherichia coli and Proteus mirabilis are the two most common infectious bacteria. Preoperative urinary tract infection (OR =4.38, 95% CI: 1.15-9.53), multiple access (OR =5.31, 95% CI: 1.23-10.75), diabetes (OR =4.97, 95% CI: 1.37-9.86), length of operation ≥60 min (OR =5.67, 95% CI: 2.24-13.42), estimated blood loss in PCNL ≥500 mL (OR=2.78, 95% CI: 2.32-3.61) were the independent risk factors associated with postoperative infection.

Conclusions: Effective control of urinary tract infection, reduction of access number, strict control of blood glucose, length of operation control, reduction of intraoperative bleeding should be considered as measures to prevent postoperative fever for patients with PCNL.

Keywords: Fever; percutaneous nephrolithotomy (PCNL); retrospective analysis; risk.