Preoperative Factors Predict Major PCNL Complications

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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