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Significance of preoperative neutrophil-lymphocyte count ratio on predicting postoperative sepsis after percutaneous nephrolithotomy.

Journal article
Authors Volkan Sen
Ibrahim Halil Bozkurt
Özgu Aydogdu
Tarik Yonguc
Serkan Yarimoglu
Pinar Sen
Omer Koras
Tansu Degirmenci
Published in The Kaohsiung journal of medical sciences
Volume 32
Issue 10
Pages 507-513
ISSN 1607-551X
Publication year 2016
Published at
Pages 507-513
Language en
Keywords Adolescent, Adult, Aged, Aged, 80 and over, Demography, Female, Humans, Lymphocyte Count, Lymphocytes, pathology, Male, Middle Aged, Multivariate Analysis, Nephrostomy, Percutaneous, adverse effects, Neutrophils, pathology, Postoperative Care, Postoperative Complications, blood, etiology, Preoperative Care, ROC Curve, Risk Factors, Sepsis, blood, etiology, Systemic Inflammatory Response Syndrome, blood, etiology, Treatment Outcome, Young Adult
Subject categories Urology and Nephrology


We evaluated the usefulness of preoperative neutrophil-lymphocyte count ratio (NLCR) in predicting postoperative sepsis after percutaneous nephrolithotomy (PCNL). In total, 487 patients who underwent PCNL for renal stones were included in the present retrospective study. The stone burden, number of tracts and location, operation time, fluoroscopy time, presence of residual stones, and blood transfusion rates were postoperatively recorded in all patients. All patients were followed up for signs of systemic inflammatory response syndrome (SIRS) and sepsis. The association of sepsis/SIRS with the risk factors of infectious complications, including NLCR, was evaluated. SIRS was detected in 91 (18.7%) patients, 25 (5.1%) of whom were diagnosed with sepsis. Stone burden, operation time, irrigation rate, previous surgery, nephrostomy time, access number, blood transfusion, residual stone, postoperative urinary culture, renal pelvis urinary culture, and stone culture were found to be predictive factors for SIRS and sepsis development. Receiver operating characteristic curve analysis revealed an NLCR cutoff of 2.50 for predicting the occurrence of SIRS/sepsis. We found that the incidence of sepsis was significantly higher in patients with NLCR ≥ 2.50 than in patients with NLCR < 2.50 (p = 0.006). Preoperative and postoperative urine culture positivity were associated with high NLCR (p = 0.039 and p = 0.003, respectively). We believe that preoperative NLCR may be a promising additive predictor of bacteremia and postoperative sepsis in patients who undergo PCNL for renal stones. This marker is simple, easily measured, and easy to use in daily practice without extra costs.

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