Introduction and Objectives
The exact mechanism of fever and urosepsis after percutaneous procedures has not been established. This research studied the frequency of fever after percutaneous nephrolithotomy (PCNL) and the risk factors.
Material and Methods
In this prospective study, 150 patients have been included. In all patients, after standard diagnostic workup and according to guidelines, PCNL was done. All patients received antibiotic treatment between day 1 and day 2. Before scheduled PCNL all patients had sterile urine. Age of the patient, previous urinary infection, type of stone, presence of nephrostomy tube and number of tracks have been analyzed.
The frequency of fever after PCNL was 14% (n = 21). The mean durations of hospitalization in patients with and without fever were 5.4±2.3 and 3.4±1.7 days, respectively (p = 0.001). In logistic regression analysis, positive urine culture, type of stone (staghorne) and presence of nephrostomy tube have been independently related to post-operative fever with classification accuracy of 90% and AUC of 0.7199. In Naive Bayes model, that except above includes and number of tracks, classification accuracy was 87.3% but AUC was 0.7222.
Fever after PCNL can be predicted in the most of patients. Both models offer very good prediction of fever after PCNL and can be used as a good prognostic tool in everyday practice.
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.