Percutaneous nephrolithotomy: factors associated with fever after the first postoperative day and systemic inflammatory response syndrome

• Published in: Journal of endourology Vol. 23; no. 6; p. 921
• Main Authors: Draga, Ronald O P, Kok, Esther T, Sorel, Marique R, Bosch, Ruud J L H, Lock, Tycho M T W
• Format: Journal Article
• Language: English
• Published: United States 01-06-2009
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Female; Fever - complications; Fever - etiology; Humans; Male; Middle Aged; Nephrostomy, Percutaneous - adverse effects; Postoperative Period; Systemic Inflammatory Response Syndrome - complications; Systemic Inflammatory Response Syndrome - etiology
• ISSN: 1557-900X
• DOI: 10.1089/end.2009.0041

Fever after the first postoperative day (POD1) after percutaneous nephrolithotomy (PCNL) is most likely caused by an infection that increases hospital stay and healthcare costs. The aim of this study was to find factors associated with fever after POD1 and systemic inflammatory response syndrome (SIRS).
Ninety patients underwent 117 PCNLs. Patient characteristics, stone burden, and pre- and postoperative treatments were analyzed for association with fever (temperature >or=38 degrees C) and SIRS using univariate analysis.
In 35% of the patients with fever (temperature >or=38 degrees C), fever was present after POD1. Twelve patients developed signs of SIRS (11.2%). In univariate analysis, significant association was observed between fever after POD1 and previous ipsilateral PCNL (p = 0.022, odds ratio OR = 3.1), and between SIRS and paraplegia (p = 0.005, OR = 10.7) and caliceal stones (p = 0.03, OR = 4.8).
Previous ipsilateral PCNL increases the risk of fever after POD1. Paraplegic patients are at risk for developing SIRS after PCNL.