Blood Parameters as a Predictor of Fever After Percutaneous Nephrolithotomy

NCT ID: NCT03774940

Last Updated: 2018-12-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

519 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-01-01

Study Completion Date

2014-01-31

Brief Summary

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

Detailed Description

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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.

Conditions

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Urinary Tract Infection Bacterial Nephrolithiasis

Keywords

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fever bacteremia lymphocytes percutaneous nephrolithotomy neutrophil-lymphocyte ratio

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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fever

patients that have fever after PNL

Group Type EXPERIMENTAL

peripheric blood count

Intervention Type DIAGNOSTIC_TEST

preoperative peripheric blood count

No fever

Patients without fever after PNL

Group Type ACTIVE_COMPARATOR

peripheric blood count

Intervention Type DIAGNOSTIC_TEST

preoperative peripheric blood count

Interventions

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peripheric blood count

preoperative peripheric blood count

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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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
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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TC Erciyes University

OTHER

Sponsor Role lead

Responsible Party

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Abdullah Demirtas

Assoc.Prof.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Abdullah Demirtas, MD

Role: PRINCIPAL_INVESTIGATOR

Erciyes University Faculty of Medicine

Locations

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Erciyes University Faculty of Medicine Department of Urology

Kayseri, , Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

References

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Reference Type BACKGROUND
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Reference Type BACKGROUND
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Goodman DA, Goodman CB, Monk JS. Use of the neutrophil:lymphocyte ratio in the diagnosis of appendicitis. Am Surg. 1995 Mar;61(3):257-9.

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de Jager CP, Wever PC, Gemen EF, Kusters R, van Gageldonk-Lafeber AB, van der Poll T, Laheij RJ. The neutrophil-lymphocyte count ratio in patients with community-acquired pneumonia. PLoS One. 2012;7(10):e46561. doi: 10.1371/journal.pone.0046561. Epub 2012 Oct 1.

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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.

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Other Identifiers

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2013/198

Identifier Type: -

Identifier Source: org_study_id