An observational study of predictive factors for fever and sepsis following percutaneous nephrolithotomy

Abstract

Background: Although percutaneous nephrolithotomy is considered a safe procedure, it is not without complications. Certain preoperative and intraoperative factors if not identified and adequately treated in time can lead to complications ranging from post operative fever to urosepsis which may seldom lead to mortality. The aim of our study is to identify those factors so as to prevent complications and promote patient safety. Methods: Retrospective analysis of medical records of the patients undergoing PCNL from January 2020 to January 2023 was done. A total of 235 patients were included in the study and associated factors analyzed statistically. Statistical analysis was performed by Chi-square test. Results: We found five factors which significantly correlated with postoperative sepsis, namely, stone size >30 mm, staghorn calculus, prolonged operative time >120 min, significant bleeding requiring transfusion and pre operative urine culture positive. Conclusions: Sepsis following PCNL is not uncommon. Progression to urosepsis maybe life threatening. Decreasing operative time decreases bleeding and related complications as well. Prophylactic antibiotics is recommended in PCNL procedure owing to its clean contaminated/contaminated surgical procedure.