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The Mayo adhesive probability score predicts postoperative fever and intraoperative hemorrhage in mini-percutaneous
Wei-An Chen1, Ho-Shiang Huang2, Ze-Hong Lu2
1School of Medicine, College of Medicine, National Cheng Kung University, Tainan, 704302, Taiwan.
Purpose:
Contemporary predictive tools for miniaturized percutaneous nephrolithotomy (mPCNL) mainly focus on stone clearance but not perioperative complications, especially infection and hemorrhage. This study aimed to evaluate whether the Mayo adhesive probability (MAP) score, an index of the perinephric fat characteristics, can predict postoperative fever and intraoperative hemorrhage in mPCNL.
Methods:
This is a retrospective study recruiting 159 mPCNL patients from July 2018 to January 2022. MAP scores were recorded using preoperative computed tomography. Postoperative complications included postoperative fever and intraoperative bleeding, defined as hemoglobin drop.
Results:
Over half patients had the MAP score ≧ 3. Men, elderly, chronic kidney disease, and diabetes were associated with a higher MAP score. The patients with a higher MAP score were more likely to have postoperative fever after mPCNL. On multivariate analysis, preoperative positive urine culture (OR 2.68) and a higher MAP score (OR 2.28) were both significantly associated with postoperative fever. ROC curves analysis of the combination of these two factors on predicting postoperative fever showed AUC values were 0.731 (0.652-0.810). Moreover, a higher MAP score (OR 2.30) and longer operative time (OR 2.16) were significantly associated with higher hemoglobin drop on multivariate analysis.
Conclusion:
A high MAP score was associated with postoperative fever and intraoperative hemorrhage in patients undergoing mPCNL. The MAP score can be a novel and easy predictive tool to help endourologists improve the awareness of mPCNL safety.
Insights
The Mayo adhesive probability (MAP) score predicts postoperative fever and bleeding in miniaturized percutaneous nephrolithotomy (mPCNL). A higher MAP score indicates increased risk, aiding urologists in improving patient safety during mPCNL procedures.
Area of Science:
- Urology
- Nephrology
- Radiology
Background:
- Miniaturized percutaneous nephrolithotomy (mPCNL) outcomes often focus on stone clearance.
- Perioperative complications like infection and hemorrhage require better predictive tools for mPCNL.
Purpose of the Study:
- To assess the Mayo adhesive probability (MAP) score's ability to predict postoperative fever and intraoperative hemorrhage in mPCNL.
- To evaluate the MAP score as a predictive index for perinephric fat characteristics in mPCNL.
Main Methods:
- Retrospective study of 159 mPCNL patients (July 2018-January 2022).
- MAP scores derived from preoperative computed tomography.
- Postoperative fever and intraoperative bleeding (hemoglobin drop) were recorded as complications.
Main Results:
- Over half of patients had a MAP score ≥ 3.
- Higher MAP scores were linked to increased risk of postoperative fever and intraoperative bleeding.
- Multivariate analysis identified preoperative positive urine culture and higher MAP score as predictors of fever; higher MAP score and longer operative time predicted bleeding.
Conclusions:
- Elevated MAP scores correlate with increased risk of postoperative fever and intraoperative hemorrhage in mPCNL.
- The MAP score serves as a novel, accessible tool for endourologists to enhance mPCNL safety awareness.
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