Analysis of Risk Factors for Developing Sepsis in Patients Who Underwent Percutaneous Nephrolithotomy at the National Kidney and Transplant Institute: A Retrospective Study

Abstract

Objective: This study aimed to identify the different risk factors for developing sepsis in patients undergoing percutaneous nephrolithotomy

Methods: This is a case-control study of all patients who underwent percutaneous nephrolithotomy in the National Kidney and Transplant Institute from 2017 to 2021. Demographic, stone characteristics, perioperative data and post-operative parameters were recorded. The association of clinical variables and sepsis was determined using logistic regression analysis.

Results: A total of 536 patients who underwent percutaneous nephrolithotomy were included in the study with 58 of them suffering from sepsis with a prevalence rate of 9.9%. The majority [392 (67.82%)] of the patients were 31-59 years old. Majority of patients suffering from sepsis also belonged to the same age group were predominantly male [33 (56.9%)], mostly diabetic [15 (26.32%)] and hypertensive [14 (24.56%)] and underwent previous PCNL [49 (8.45%)]. Imaging of patients who had sepsis showed staghorn calculi [30 (51.72%)] with mild [20 (34.48%)] and moderate [23 (39.66%)] seen on imaging. Patients who were requiring transfusion post operatively (Grade II Clavien-Dindo Classification) were seen to have sepsis.

Conclusion: The following factors are contributory to the development of sepsis: a high Guy's stone score, high degree of obstruction or hydronephrosis, previous stone surgery and a higher volume of blood loss.