Systemic inflammatory response syndrome (SIRS) in patients undergoing percutaneous nephrolithotomy. A cross-sectional study.
DOI:
https://doi.org/10.51168/0yzm9p69Keywords:
Urolithiasis, risk factors, WBC count, Systemic Inflammatory Response SyndromeAbstract
Introduction
Urolithiasis, commonly referred to as kidney stones, affects a substantial proportion of the global population. The study aims to analyse perioperative factors that may predict the occurrence of Systemic Inflammatory Response Syndrome (SIRS) in patients undergoing Percutaneous Nephrolithotomy.
Methodology
A cross-sectional observational study using quantitative methods of data collection was carried out. A total of 90 patients over a period of 1 year in the urology department, JSS Medical College and Hospital, JSSAHER, Mysuru, Karnataka, India. The study included patients requiring PCNL surgery from the Department of Urology, JSS Medical College and Hospital.
Results
The gender distribution reveals a male predominance in the study, with 64.4% (58 participants) being male and 35.6% (32 participants) female. Diabetes was significantly associated with SIRS (p = 0.040). Diabetic patients had a higher SIRS occurrence (30.8%) compared to non-diabetic individuals (12.5%), indicating that impaired immunity and metabolic dysfunction in diabetes may contribute to greater systemic inflammatory response. Patients with a prior history of urology surgery had a higher occurrence of SIRS (25%) compared to those without such history (14.5%). However, the difference was not statistically significant (p = 0.228). Urine culture positivity was significantly associated with SIRS (p = 0.000). Among patients with negative cultures, only 7% developed SIRS, whereas 57.9% of those with positive cultures did.
Conclusion
WBC count, haemoglobin, and procalcitonin levels were found to be important in assessing the risk of SIRS. Operative factors like prolonged operative time (>60 minutes) and stone characteristics (size and number) were also found to be significantly associated with SIRS.
Recommendations
Patients with certain risk factors, such as diabetes, dyslipidemia, and urinary tract infections, should be closely monitored for signs of SIRS after PCNL.
References
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