Blood Parameters as a Predictor of Fever After Percutaneous Nephrolithotomy

Nephrolithiasis Clinical Trial

Official title:

Neutrophil and Lymphocyte Counts and the Neutrophil-to-lymphocyte Ratio as a Predictor of Fever Following Percutaneous Nephrolithotomy in Patients Without Risk Factors

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03774940
• Other study ID #: 2013/198
• Status: Completed
• Phase: N/A
• Start date: January 1, 2005
• Est. completion date: January 31, 2014

Study information

• Verified date: December 2018
• Source: TC Erciyes University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

To investigate the relationship between neutrophil count, lymphocyte count, neutrophil-to-lymphocyte count ratio (NLR), and postoperative fever in patients undergoing percutaneous nephrolithotomy (PNL).

Description:

Percutaneous nephrolithotomy (PNL) is a minimally invasive treatment commonly used for renal calculi. However, the prevalence of postoperative fever is reported to be 16.7%-35%, even with appropriate prophylactic antibiotic therapy and a sterile urine culture. The most probable causes are urinary extravasation and bacteremia. Although it is important to postoperatively isolate the causative bacteria, bacterial isolation may not always be possible, and urinary and blood cultures may prove negative. In addition, establishing the etiology of fever could be time-consuming and the techniques involved may generate pseudo-negative results owing to several factors, especially the antibiotics used prophylactically. This can result in a prolonged hospital stay and increased the cost of patient care.

The most commonly used parameters for the early diagnosis of bacterial infections, despite their limited use, are C-reactive protein, white blood cell count, and neutrophil count . Superior parameters include procalcitonin, pro-adrenomedullin, interleukin (IL)-6, and IL-8, but their use is limited by their lack of availability in some centers and their higher costs. Recently, the ratio of neutrophil count to lymphocyte count (NLR) has been proposed as an effective, simple, and useful biomarker for the early diagnosis of bacterial infections. However, these tests are used after the emergence of fever. As yet, no single parameter has been proposed for predicting postoperative fever in the absence of preoperative factors known to cause fever.

The aim of this study was to investigate whether neutrophil count, lymphocyte count, and NLR obtained from routine preoperative blood tests could be used in predicting fever following PNL in patients with no risk factors for infection.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 519
• Est. completion date: January 31, 2014
• Est. primary completion date: December 1, 2013
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• underwent PNL operation

• preoperative white blood cell count between 4,000 and 12,000/µL

Exclusion Criteria:

• preoperative urinary system obstruction

• proliferation in preoperative and/or postoperative urine culture

• preoperative and/or postoperative blood transfusions

• a preoperative urinary diversion and/or intervention

• the presence of a postoperative residual stone

• the presence of malignancy,

• the presence of a hematologic disease.

• patients with postoperative complications graded as Clavien 2 and above

Related Conditions & MeSH terms

• Bacterial Infections
• Kidney Calculi
• Nephrolithiasis
• Urinary Tract Infection Bacterial
• Urinary Tract Infections

Intervention

Diagnostic Test:
• peripheric blood count
preoperative peripheric blood count

Locations

Country	Name	City	State
Turkey	Erciyes University Faculty of Medicine Department of Urology	Kayseri

Sponsors (1)

Lead Sponsor	Collaborator
TC Erciyes University

Country where clinical trial is conducted

Turkey, 

References & Publications (21)

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Sen V, Bozkurt IH, Aydogdu O, Yonguc T, Yarimoglu S, Sen P, Koras O, Degirmenci T. Significance of preoperative neutrophil-lymphocyte count ratio on predicting postoperative sepsis after percutaneous nephrolithotomy. Kaohsiung J Med Sci. 2016 Oct;32(10):507-513. doi: 10.1016/j.kjms.2016.08.008. Epub 2016 Sep 9. — View Citation

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Sharifi Aghdas F, Akhavizadegan H, Aryanpoor A, Inanloo H, Karbakhsh M. Fever after percutaneous nephrolithotomy: contributing factors. Surg Infect (Larchmt). 2006 Aug;7(4):367-71. — View Citation

Tang K, Liu H, Jiang K, Ye T, Yan L, Liu P, Xia D, Chen Z, Xu H, Ye Z. Predictive value of preoperative inflammatory response biomarkers for metabolic syndrome and post-PCNL systemic inflammatory response syndrome in patients with nephrolithiasis. Oncotarget. 2017 Aug 18;8(49):85612-85627. doi: 10.18632/oncotarget.20344. eCollection 2017 Oct 17. — View Citation

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* Note: There are 21 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	White blood cell count	white blood cell count	preoperative
Primary	Neutrophil count	neutrophil count	preoperative
Primary	N/L	ratio of neutrophil count to lymphocyte count	preoperative
Primary	Lymphocyte count	Lymphocyte count	preoperative