• Ekrem Akdeniz, Kemal Ozturk, Muhammed Bahattin Ulu, Metin Gur, Suleyman Tumer Caliskan, and Emine Sehmen.
• Department of Urology, Gazi Hospital, Samsun, Turkey.
• J Coll Physicians Surg Pak. 2021 Apr 1; 31 (4): 410416410-416.

ObjectiveTo explore the risk factors for systemic inflammatory response syndrome (SIRS) after percutaneous nephrolithotomy (PCNL) in patients with preoperative negative urine culture (UC).Study DesignObservational study.Place And Duration Of StudyDepartment of Urology, Gazi Hospital, Samsun, Turkey, from January 2015 to January 2020.MethodologyTwo hundred and twenty-eight patients, who underwent conventional PCNL for renal stones, were evaluated. The patients were divided into non-SIRS (Group 1) and SIRS (Group 2) groups, and the effects of the variables were investigated to predict the development of SIRS.ResultsDespite preoperative sterile UC, SIRS developed postoperatively in 29 (12.7%) patients. The univariate analysis revealed a statistically significant difference between groups in preoperative serum C-reactive protein (CRP) (p <0.001), platelet-to-lymphocyte ratio (PLR) (p <0.001), neutrophil-to-lymphocyte ratio (p = 0.001), urine white blood cell (p = 0.034), stone size (p = 0.023), operative time (p = 0.041), hemoglobin drop (p <0.001), blood transfusion (p = 0.002), hospital stay (p = 0.006), and complication rate (p = 0.001). Receiver operating characteristic analysis indicated that PLR >117.36 (p <0.001), CRP >3.16 mg/L (p <0.001), stone burden >471 mm2 (p = 0.023) and hemoglobin drop >2.3 g/L (p <0.001) are independent risk factors for post-operative SIRS after PCNL.ConclusionPLR, CRP, stone size, and hemoglobin drop can predict SIRS after PCNL. This finding may help classify risk in patients before PCNL, especially in those with a sterile urine culture. Key Words: C-reactive protein, Percutaneous nephrolithotomy, Platelet/lymphocyte ratio, Systemic inflammatory response syndrome.

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