Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100, Haining Road, Hongkou District, Shanghai, 200080, People's Republic of China.
Department of Gerontology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100, Haining Road, Hongkou District, Shanghai, People's Republic of China.
Urolithiasis. 2019 Oct;47(5):455-460. doi: 10.1007/s00240-019-01115-3. Epub 2019 Feb 12.
To evaluate the role of preoperative procalcitonin (PCT) levels in predicting postoperative fever after mini-percutaneous nephrolithotomy (mini-PCNL) in patients with a negative baseline urine culture. Between January 2014 and October 2017, 329 patients with a negative baseline urine culture and who underwent mini-PCNL were enrolled in this study. Patients were stratified into the control or febrile group based on a body temperature either less than or greater than 38 °C, respectively. Demographic and perioperative data were compared between the groups, and variables found to be statistically significant were included in a binary logistic regression analysis. A total of 68 (20.6%) patients experienced postoperative fever. The univariate analysis revealed a statistically significant difference between groups in preoperative fever (p = 0.032), stone burden (p < 0.001), C-reactive protein (p = 0.011), PCT (p < 0.001) and interleukin-6 (p = 0.035) levels. Binary logistic regression analysis indicated that stone burden > 353 mm (p = 0.003) and PCT > 0.05 ng/mL (p < 0.001) are independent risk factors for postoperative fever in mini-PCNL-treated patients with a negative baseline urine culture. We concluded that patients with stone burden > 353 mm or PCT > 0.05 ng/mL were more likely to develop postoperative fever after mini-PCNL, though with a negative baseline urine culture.
评估术前降钙素原(PCT)水平在预测阴性基线尿培养的微创经皮肾镜取石术(mini-PCNL)后发热中的作用。
2014 年 1 月至 2017 年 10 月,纳入 329 例基线尿培养阴性且接受 mini-PCNL 的患者。根据体温(<38℃或>38℃)将患者分为对照组或发热组。比较两组患者的一般资料和围手术期数据,将具有统计学意义的变量纳入二项逻辑回归分析。
共 68 例(20.6%)患者发生术后发热。单因素分析显示,两组患者术前发热(p=0.032)、结石负荷(p<0.001)、C 反应蛋白(p=0.011)、PCT(p<0.001)和白细胞介素-6(p=0.035)水平存在统计学差异。二项逻辑回归分析表明,结石负荷>353mm(p=0.003)和 PCT>0.05ng/ml(p<0.001)是阴性基线尿培养 mini-PCNL 术后发热的独立危险因素。
尽管基线尿培养阴性,但结石负荷>353mm 或 PCT>0.05ng/ml 的患者更易发生 mini-PCNL 术后发热。