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Predictive value of Controlling Nutritional Status score and Prognostic Nutritional Index for systemic inflammatory response syndrome/sepsis after percutaneous nephrolithotomy

  • Urology - Original Paper
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Abstract

Purpose

Our aim was to investigate the predictive value of Controlling Nutritional Status (CONUT) score and Prognostic Nutritional Index (PNI) for systemic inflammatory response syndrome (SIRS)/sepsis after percutaneous nephrolithotomy (PNL).

Methods

Demographic and clinical data of 422 patients who underwent PNL were evaluated. The CONUT score was calculated from lymphocyte count, serum albumin, and cholesterol, while the PNI was calculated using lymphocyte count and serum albumin. Spearman’s correlation coefficient was used to evaluate the relationship between nutritional scores and systemic inflammation markers. Logistic regression analysis was performed to determine the risk factors for SIRS/sepsis development after PNL.

Results

Patients with SIRS/sepsis had a significantly higher preoperative CONUT score and lower PNI compared with the SIRS/sepsis (−) group. A positive significant correlation between CONUT score and CRP (rho = 0.75), CONUT score and procalcitonin (rho = 0.36), and CONUT score and WBC (rho = 0.23) were determined. Additionally, a negative significant correlation was shown between PNI and procalcitonin (rho = − 0.30) and PNI and CRP (rho = − 0.64). The ROC curve analysis showed that the cut-off values for the CONUT score and PNI were 4 (AUC = 0.827) and 42 (AUC = 0.734), respectively. Age, stone size, history of pyelonephritis, residual stone, presence of infection stone, CONUT score ≥ 4, and PNI ≤ 42 were found to be independent predictors for postoperative SIRS/sepsis in multivariate analysis.

Conclusion

Our results demonstrated that preoperative CONUT score and PNI are potential predictive factors for SIRS/sepsis development after PNL. Therefore, patients with CONUT score ≥ 4 and PNI ≤ 42 are suggested to be closely monitoring due to the risk of post-PNL SIRS/sepsis.

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Data availability

The datasets generated during or analysed during the current study are available from the corresponding author on reasonable request.

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Funding

The authors did not receive support from any organization for the submitted work. The authors have no relevant financial or non-financial interests to disclose.

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Authors and Affiliations

  1. Department of Urology, University of Health Sciences Gaziosmanpaşa Training and Research Hospital, Karayolları Str. No:621 Gaziosmanpaşa, Istanbul, Turkey

    Burak Arslan, Abdullah Harun Kinik, Serkan Gonultas, Mustafa Gökhan Kose, Sina Kardas, Buğra Cetin, Arif Kecebas, Doğan Altay & Enver Ozdemir

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  1. Burak Arslan
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  2. Abdullah Harun Kinik
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Correspondence to Burak Arslan.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the ethical committee of University of Health Sciences Gaziosmanpaşa Training and Research Hospital (approval no: 2021/373).

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Arslan, B., Kinik, A.H., Gonultas, S. et al. Predictive value of Controlling Nutritional Status score and Prognostic Nutritional Index for systemic inflammatory response syndrome/sepsis after percutaneous nephrolithotomy. Int Urol Nephrol 55, 1101–1107 (2023). https://doi.org/10.1007/s11255-023-03559-4

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