Preoperative Factors Predict Major PCNL Complications

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Female patients with high comorbidity burden and complex kidney stones are at higher risk.
Female patients with high comorbidity burden and complex kidney stones are at higher risk.

Female gender, a high comorbidity burden, and complex kidney stones predict a greater likelihood of serious complications from percutaneous nephrolithotomy (PCNL), a new study suggests.

In a retrospective study of 354 PCNL patients with an average age of 47 years, researchers found that women had a 3-fold increased risk of serious complications (Clavien grade 3 or higher) than men, according to an online report in the Journal of Endourology.

Patients with a Charlson score of 3 or higher had a 23.2 times increased risk compared with those who had a Charlson score of 1–2. Patients with a complex stone had a 4-fold increased risk compared with those who did not. In addition, a surgery duration time of 120 minutes or more was associated with a nearly 3-fold increased risk of serious complications compared with shorter surgery duration.

The researchers, led by Jorge Moreno-Palacios, MD, MS, of UMAE Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México D.F., México, reported that the stone-free rates for non-complex and complex stones were 85% and 68%, respectively.

“Defining of preoperative [risk] factors will help to better select patients and prevent complications and improve surgical outcomes,” the authors concluded.

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