Dinçer Erdinç, Özkaptan Orkunt, Çanakçı Cengiz, Ipek Osman Murat, Can Utku, Can Murat
Department of Urology, Health Sciences University, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey.
Urolithiasis. 2025 Aug 4;53(1):151. doi: 10.1007/s00240-025-01823-z.
To investigate the association between infectious complications following percutaneous nephrolithotomy (PCNL) and renal pelvis urine density (RPUD) measured on preoperative non-contrast-enhanced computed tomography scans.This retrospective cohort study was conducted on patients who underwent PCNL between January 2020 and December 2024. Preoperative non-contrast-enhanced computed tomography was used to assess stone characteristics and RPUD measurement. Patients were categorized into infectious and non-infectious groups based on postoperative infectious complications. The groups were compared in terms of demographic data, stone characteristics (stone burden, localization, stone density), length of stay and RPUD.The study included 273 patients (76% male; 24% female). The median RPUD value was 13.1 ± 4.9 in the non-infectious group and 17.2 ± 4.6 in the infectious group (p < 0.001). Age, sex, BMI, ASA score, diabetes mellitus, stone side and localization were similar in both groups. In the multivariate analysis, stone density and RPUD were found to be associated with postoperative infectious complications (p = 0.034, p = 0.001, respectively). Postoperative infection risk increased 1.13-fold with each unit (HU) increase in RPUD. The cut-off value of RPUD value was 15.15 for predicting postoperative infection, with 66.6% sensitivity and 65.8% specificity (AUC: 0.702, 95% CI = 0.615-0.79, p < 0.001).This study demonstrated a significant association between higher preoperative RPUD values and the development of infectious complications following PCNL. RPUD-a simple measurement obtained from preoperative CT scans-may serve as an early indicator of infection risk and support prophylactic antibiotic planning or drainage decision-making.
为了研究经皮肾镜取石术（PCNL）后感染性并发症与术前非增强计算机断层扫描测量的肾盂尿液密度（RPUD）之间的关联。本回顾性队列研究针对2020年1月至2024年12月期间接受PCNL的患者进行。术前非增强计算机断层扫描用于评估结石特征和RPUD测量。根据术后感染性并发症将患者分为感染组和非感染组。比较两组的人口统计学数据、结石特征（结石负荷、位置、结石密度）、住院时间和RPUD。该研究纳入了273例患者（76%为男性；24%为女性）。非感染组的RPUD中位数为13.1±4.9，感染组为17.2±4.6（p<0.001）。两组在年龄、性别、体重指数、美国麻醉医师协会（ASA）评分、糖尿病、结石侧别和位置方面相似。多因素分析发现，结石密度和RPUD与术后感染性并发症相关（分别为p=0.034，p=0.001）。RPUD每增加一个单位（HU），术后感染风险增加1.13倍。RPUD预测术后感染的临界值为15.15，敏感性为66.6%，特异性为65.8%（曲线下面积：0.702，95%置信区间=0.615-0.79，p<0.001）。本研究表明，术前较高的RPUD值与PCNL后感染性并发症的发生之间存在显著关联。RPUD——一种从术前CT扫描获得的简单测量指标——可能作为感染风险的早期指标，并有助于预防性抗生素方案的制定或引流决策。
