Fever and Systemic Inflammatory Response Syndrome Seen After Percutaneous Nephrolithotomy: Review of 1290 Adult Patients

dc.contributor.authorEgilmez, Tulga
dc.contributor.authorGoren, Mehmet Resit
dc.date.accessioned2019-12-06T12:46:57Z
dc.date.available2019-12-06T12:46:57Z
dc.date.issued2015
dc.description.abstractAim: Although accepted as minimally invasive, percutaneous nephrolithotomy (PCNL) still poses a significant risk of complications. Recent studies suggest that the incidence of sepsis may be higher than previously reported. The systemic inflammatory response syndrome (SIRS) seen in the subset of patients with or without bacteremia, is a life threatening complication and the purpose of this study is to give an insight to the relation between a post-operative fever episode and the risk of developing SIRS. Material and Method: Medical files of 1646 adult patients to whom a PCNL operation was performed were reviewed. A total of 1290 patients fulfilled the needed criteria and were included in the study. Study variables were recorded from the medical files for statistical analysis. Results: Stone burden had a statistically significant correlation with SIRS (p<0.05) but not with fever. Comorbidities of the patients alone did not have a correlation with fever or SIRS. But ASA score 3 and 4 showed statistically significant correlations with SIRS (p<0.05). Majority of the 288 complications encountered were Clavian grade 2 and grade >= 2 complications were seen to increase the hospitalization period (p<0.05). Operation time >= 120 min. was the only operative variable that had correlation with both fever and SIRS (p<0.05). Blood loss >2 g/dl (Delta haemoglobin-Hb) and Clavian 5 complications had statistically significant correlations with fever. ASA score >= 3, operation time >120 min. Delta Hb > 2 gr/dl, stone size and Clavian 5 complications had statistically significant correlations with the development of SIRS. The incidence of a fever episode, which was seen in 181 patients (14%), to progress to SIRS, which leaded to death, was found to be 1.6%. Discussion: Postoperative fever has a low risk of progressing to a life threatening condition. But special attention should be given to patients that also have the other SIRS criteria; blood loss more than 2 g/dl and/or operation time more than 120 minutes. Although only encountered in a small subset of patients, multiple organ dysfunctions can develop leading to death.en_US
dc.identifier.endpage201en_US
dc.identifier.issn1309-0720
dc.identifier.issue2en_US
dc.identifier.scopus2-s2.0-84928565571en_US
dc.identifier.startpage196en_US
dc.identifier.urihttp://www.bayrakol.org/en/2015/march2015/original-article/item/1003-fever-and-systemic-inflammatory-response-syndrome-seen-after-percutaneous-nephrolithotomy-review-of-1290-adult-patients
dc.identifier.urihttp://hdl.handle.net/11727/4359
dc.identifier.volume6en_US
dc.identifier.wos000376563600030en_US
dc.language.isoengen_US
dc.relation.isversionof10.4328/JCAM.1949en_US
dc.relation.journalJOURNAL OF CLINICAL AND ANALYTICAL MEDICINEen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergien_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectPercutaneous Nephrolithotomyen_US
dc.subjectSystemic Inflammatory Response Syndromeen_US
dc.subjectFeveren_US
dc.titleFever and Systemic Inflammatory Response Syndrome Seen After Percutaneous Nephrolithotomy: Review of 1290 Adult Patientsen_US
dc.typearticleen_US

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