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Significance of preoperative systemic immune-inflammation (SII) in predicting postoperative systemic inflammatory response syndrome after percutaneous nephrolithotomy

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Abstract

There is evidence that inflammation response biomarkers are positivity associated with bacteremia and urosepsis. The objective of this study was to investigate the value of preoperative systemic immune-inflammation (SII) in predicting systemic inflammatory response syndrome (SIRS) after percutaneous nephrolithotomy (PCNL). Records from 365 consecutive patients who previously received standard PCNL for kidney stones were retrospectively reviewed. Exactly 108 (29.6%) of the 365 patients who underwent PCNL developed SIRS postoperatively. The association of SIRS with the preoperative risk factors of infectious complications was evaluated. Female gender, operating time, SII, neutrophil to lymphocyte ratio (NLR), and lymphocyte to monocyte ratio (LMR) were found to be independent predictors for post-PCNL SIRS. Female patients with SIRS were more likely to have positive urine culture, a higher level of serum leukocyte, and serum hs-CRP than male patients with SIRS. Receiver operating characteristic curve analysis indicated SII for predicting the occurrence of SIRS with a higher AUC (0.782) than other systemic inflammation biomarkers such as LMR (0.734), NLR (0.671), and PLR (0.617). As a novel integrated inflammation biomarker for predicting SIRS after PCNL, SII showed a better predictive value than other traditional inflammation indicators. To our knowledge, we present the first study to investigate the predictive value of the preoperative SII on post‐PCNL SIRS.

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Abbreviations

SIRS:

Systemic inflammatory response syndrome

PCNL:

Percutaneous nephrolithotomy

SII:

Systemic immune-inflammation, neutrophil count × platelet count/lymphocyte count

NLR:

Neutrophil to lymphocyte ratio

LMR:

Lymphocyte to monocyte ratio

PLR:

Platelet to lymphocyte ratio

References

  1. Türk C, Petřík A, Sarica K, Seitz C, Skolarikos A, Straub M, Knoll T (2016) EAU guidelines on interventional treatment for urolithiasis. Eur Urol 69:475–482

    Article  Google Scholar 

  2. Martin GS, Mannino DM, Eaton S, Moss M (2003) The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med 348:1546–1554

    Article  Google Scholar 

  3. de la Rosette J, Assimos D, Desai M, Gutierrez J, Lingeman J, Scarpa R, Tefekli A (2011) CROES PCNL study group. The clinical research offifice of the endourological society percutaneous nephrolithotomy global study: indications, complications and outcomes in 5803 patients. J Endourol 25:11–17

    Article  Google Scholar 

  4. Lucca I, de Martino M, Hofbauer SL, Zamani N, Shariat SF, Klatte T (2015) Comparison of the prognostic value of pretreatment measure ments of systemic inflammatory response in patients undergoing curative resection of clear cell renal cell carcinoma. World J Urol 33:2045–2052

    Article  CAS  Google Scholar 

  5. Belen E, Sungur A, Sungur MA, Erdogan G (2015) Increased neutrophil to lymphocyte ratio in patients with resistant hypertension. J Clin Hypertens 17:532–537

    Article  CAS  Google Scholar 

  6. Sidaway P (2015) Prostate cancer: platelet-tolymphocyte ratio predicts prostate cancer prognosis. Nat Rev Urol 12:238

    Article  Google Scholar 

  7. Cetinkaya M, Buldu I, Kurt O, Inan R (2017) Platelet-to-lymphocyte ratio: a new factor for predicting systemic inflammatory response syndrome after percutaneous nephrolithotomy. Urol J 14:4089–4093

    PubMed  Google Scholar 

  8. Sen V, Bozkurt IH, Aydogdu O, Yonguc T, Yarimoglu S, Sen P, Koras O, Degirmenci T (2016) Significance of preoperative neutrophil-lymphocyte count ratio on predicting postoperative sepsis after percutaneous nephrolithotomy. Kaohsiung J Med Sci 32:507–513

    Article  Google Scholar 

  9. Wang K, Diao F, Ye Z, Zhang X, Zhai E, Ren H, Li T, Wu H, He Y, Cai S, Chen J (2017) Prognostic value of systemic immune-infammation index in patients with gastric cancer. Chin J Cancer 36:75

    Article  Google Scholar 

  10. Lolli C, Caffo O, Scarpi E, Aieta M, Conteduca V, Maines F, Bianchi E, Massari F, Veccia A, Chiuri VE, Facchini G, De Giorgi U (2016) Systemic immuneinfammation index predicts the clinical outcome in patients with mCRPC treated with abiraterone. Front Pharmacol 7:376

    Article  CAS  Google Scholar 

  11. Man YN, Chen YF (2019) Systemic immune-inflammation index, serum albumin, and fibrinogen impact prognosis in castration-resistant prostate cancer patients treated with first-line docetaxel. Int Urol Nephrol 51:2189–2199

    Article  CAS  Google Scholar 

  12. Draga RO, Kok ET, Sorel MR, Bosch RJ, Lock TM (2009) Percutaneous nephrolithotomy: factors associated with fever after the first postoperative day and systemic inflammatory response syndrome. J Endourol 23:921–927

    Article  Google Scholar 

  13. Mariappan P, Smith G, Moussa SA, Tolley DA (2006) One week of ciprofloxacin before percutaneous nephrolithotomy significantly reduces upper tract infection and urosepsis: a prospective controlled study. BJU Int 98:1075–1079

    Article  Google Scholar 

  14. Koras O, Bozkurt IH, Yonguc T, Degirmenci T, Arslan B, Gunlusoy B, Aydogdu O, Minareci S (2014) Risk factors for postoperative infectious complications following percutaneous nephrolithotomy: a prospective clinical study. Urolithiasis 43:55–60

    Article  Google Scholar 

  15. Dogan HS, Guliyev F, Cetinkaya YS, Sofikerim M, Ozden E, Sahin A (2007) Importance of microbiological evaluation in management of infectious complications following percutaneous nephrolithotomy. Int Urol Nephrol 39:737–742

    Article  Google Scholar 

  16. Chen L, Xu QQ, Li JX, Xiong LL, Wang XF, Huang XB (2008) Systemic inflammatory response syndrome after percutaneous nephrolithotomy: an assessment of risk factors. Int J Urol 15:1025–1028

    Article  Google Scholar 

  17. Gutierrez J, Smith A, Geavlete P, Shah H, Kural AR, de Sio M, Amón Sesmero JH, Hoznek A, de la Rosette J (2013) CROES PCNL study group. Urinary tract infections and post-operative fever in percutaneous nephrolithotomy. World J Urol 31:1135–1140

    Article  Google Scholar 

  18. Tang K, Liu H, Jiang K, Ye T, Yan L, Liu P, Xia D, Chen Z, Xu H, Ye Z (2017) Predictive value of preoperative inflammatory response biomarkers for metabolic syndrome and post-PCNL systemic inflammatory response syndrome in patients with nephrolithiasis. Oncotarget 8:85612–85627

    Article  Google Scholar 

  19. Hu B, Yang XR, Xu Y, Sun YF, Sun C, Guo W, Zhang X, Wang WM, Qiu SJ, Zhou J, Fan J (2014) Systemic immuneinflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res 20:6212–6222

    Article  CAS  Google Scholar 

  20. Passardi A, Scarpi E, Cavanna L, Dall’Agata M, Tassinari D, Leo S, Bernardini I, Gelsomino F, Tamberi S, Brandes AA, Tenti E, Vespignani R, Frassineti GL, Amadori D, De Giorgi U (2016) Infammatory indexes as predictors of prognosis and bevacizumab efficacy in patients with metastatic colorectal cancer. Oncotarget 7:33210–33219

    Article  Google Scholar 

  21. Singh P, Yadav S, Singh A, Saini AK, Kumar R, Seth A, Dogra PN (2016) Systemic inflammatory response syndrome following percutaneous nephrolithotomy: assessment of risk factors and their impact on patient outcomes. Urol Int 96:207–211

    Article  CAS  Google Scholar 

  22. Mariappan P, Smith G, Bariol SV, Moussa SA, Tolley DA (2005) Stone and pelvic urine culture and sensitivity are better than bladder urine as predictors of urosepsis following percutaneous nephrolithotomy: a prospective clinical study. J Urol 173:1610–1614

    Article  Google Scholar 

  23. Wang Y, Jiang F, Wang Y, Hou Y, Zhang H, Chen Q, Xu N, Lu Z, Hu J, Lu J, Wang X, Hao Y, Wang C (2012) Post-percutaneous nephrolithotomy septic shock and severe hemorrhage: a study of risk factors. Urol Int 88:307–310

    Article  CAS  Google Scholar 

  24. Uchida Y, Takazawa R, Kitayama S, Tsujii T (2018) Predictive risk factors for systemic inflammatory response syndrome following ureteroscopic laser lithotripsy. Urolithiasis 46:375–381

    Article  Google Scholar 

  25. Xun Y, Yang Y, Yu X, Li C, Lu J, Wang S (2020) A preoperative nomogram for sepsis in percutaneous nephrolithotomy treating solitary, unilateral and proximal ureteral stones. Peer J 8:e9435

    Article  Google Scholar 

  26. Zhu C, Liu H, Wang Y, Jiao J, Li Z, Cao J, Song B, Jin J, Liu Y, Wen X, Cheng S, Wu X (2019) Prevalence, incidence, and risk factors of urinary tract infection among immobile inpatients in China: a prospective, multi-centre study. J Hosp Infect 104:538–544

    Article  Google Scholar 

  27. King BJ, Seufert CJ, Okhunov Z, Khater N, Baldwin DD, Callas PW, Sternberg KM (2017) Profile of metabolic and infectious stone-formers in a contemporary PCNL cohort. Can J Urol 24:8641–8645

    PubMed  Google Scholar 

  28. Daudon M, Donsimoni R, Hennequin C, Fellahi S, Le Moel G, Paris M, Troupel S, Lacour B (1995) Sex- and age-related composition of 10 617 calculi analyzed by infrared spectroscopy. Urol Res 23:319–326

    Article  CAS  Google Scholar 

  29. Mulay SR, Kulkarni OP, Rupanagudi KV, Migliorini A, Darisipudi MN, Vilaysane A, Muruve D, Shi Y, Munro F, Liapis H, Anders HJ (2013) Calcium oxalate crystals induce renal inflammation by NLRP3-mediated IL-1β secretion. J Clin Invest 123:236–246

    Article  CAS  Google Scholar 

  30. Khan SR (2004) Crystal-induced inflammation of the kidneys: results from human studies, animal models, and tissue-culture studies. Clin Exp Nephrol 8:75–88

    Article  CAS  Google Scholar 

  31. de Water R, Noordermeer C, Houtsmuller AB, Nigg AL, Stijnen T, Schröder FH, Kok DJ (2000) Role of macrophages in nephrolithiasis in rats: an analysis of the renal interstitium. Am J Kidney Dis 36:615–625

    Article  Google Scholar 

  32. Cohen J, Vincent JL, Adhikari NK, Machado FR, Angus DC, Calandra T, Jaton K, Giulieri S, Delaloye J, Opal S, Tracey K, van der Poll T, Pelfrene E (2015) Sepsis: a roadmap for future research. Lancet Infect Dis 15:581–614

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Urology, Shaoxing People’s Hospital, Shaoxing, 312000, China

    Chao Peng, Junlong Li, Gang Xu, Jing Jin, Jiajun Chen & Shouhua Pan

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  1. Chao Peng
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  2. Junlong Li
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  3. Gang Xu
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  4. Jing Jin
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  5. Jiajun Chen
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Correspondence to Shouhua Pan.

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This study was approved by the Institutional Ethics Committee (IEC) of Shaoxing People’s Hospital. All participants provided written informed consent.

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Peng, C., Li, J., Xu, G. et al. Significance of preoperative systemic immune-inflammation (SII) in predicting postoperative systemic inflammatory response syndrome after percutaneous nephrolithotomy. Urolithiasis 49, 513–519 (2021). https://doi.org/10.1007/s00240-021-01266-2

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  • DOI: https://doi.org/10.1007/s00240-021-01266-2

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