Pre-Operative Parameters Predicting Hemoglobin Decline Related to Percutaneous Nephrolithotomy

Area of Science:

• Urology
• Nephrology
• Surgical Complications

Background:

• Percutaneous nephrolithotomy (PNL) is a primary treatment for upper urinary tract stones.
• While effective, PNL carries risks, notably bleeding, a significant complication.

Purpose of the Study:

• To identify risk factors associated with bleeding after PNL.
• To analyze predictors of post-operative hemoglobin reduction.

Main Methods:

• Retrospective analysis of 169 patients undergoing PNL (January 2017 - December 2018).
• Patients categorized into two groups based on a 1.6 g/dl median hemoglobin decrease threshold.
• Pre-operative, perioperative, and stone characteristic data were collected and analyzed.

Main Results:

• Higher mean age, hypertension (HT), and greater stone burden were observed in the significant bleeding group (Group 1).
• Increased operative times and higher complication rates were associated with significant hemoglobin decline.
• Multivariate analysis identified advanced age and HT as independent risk factors for hemoglobin reduction.

Conclusions:

• Advanced age, hypertension, and high stone burden are predictive of hemoglobin reduction post-PNL.
• Decreased hemoglobin levels correlate with operative duration and complication incidence.
• These findings aid in identifying patients at higher risk for bleeding during PNL.