Predictive Values of Neutrophil to Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio for Systemic Inflammatory Response Syndrome after Percutaneous Nephrolithotomy

Introduction: Percutaneous nephrolithotomy (PNL) is widely used for kidney stones. One of the complications of PNL is Systemic inflammatory response syndrome (SIRS), which is of great importance. Here we wanted to estimate the effectiveness of neutrophil to lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in predicting SIRS following PNL. Methods: This study is prospective observational work done in ۲۰۱۸-۲۰۱۹ in Isfahan, Iran, on patients diagnosed with kidney stones that were candidates of PNL. We collected patient demographic data, including gender, age, and size of kidney stones. Information about the operation duration, procedures, and laboratory data were collected before and after the procedures. All data were compared between patients with or without SIRS after PNL. Results: In the present study, ۱۵۲ candidates for PNL entered the research. The average age of the patients was ۵۲.۱± ۱۳.۴ years. In this study, ۹۵ patients (۶۲.۵%) were male, and ۵۷ (۳۷.۵%) were female. The average stone size was ۲۹.۴± ۵.۳ mm. Based on our data; ۲۶ patients (۱۷.۱%) had sepsis after the procedure. There was only a significant difference between groups of patients regarding primary stone composition in the way that ۹۲.۳% of cases with sepsis had two stone compositions while ۴۴.۴% of other patients had two stone compositions and ۵۰% had one stone composition (P-value<۰.۰۰۱). We found that patients that had sepsis after PNL had significantly higher operation duration (P-value=۰.۰۴۴) and significantly higher packed cell transfusion (۳۰.۸%) compared to other patients (۴%) (P-value<۰.۰۰۱). The NLR below ۷۲.۲ could predict sepsis after PNL with ۸۰.۵% sensitivity and ۳۳.۳% specificity. Furthermore, the PLR below ۶۳.۳ could predict sepsis after PNL with ۹۰.۹% sensitivity and ۵.۳% specificity.Conclusion: Elevated NLR and PLR are associated with increased frequencies of SIRS after PNL. These data could be used effectively in predicting SIRS in these patients.

Keywords:

Systemic inflammatory response syndrome , Percutaneous nephrolithotomy , neutrophil to lymphocyte ratio , platelet-to-lymphocyte ratio