Saturation effect between operation time and post-PCNL SIRS in pediatric patients

Area of Science:

• Pediatric Urology
• Surgical Outcomes Research
• Nephrolithiasis Management

Background:

• Prolonged surgical duration is linked to complications in various procedures.
• The impact of operation time on pediatric percutaneous nephrolithotomy (PCNL) outcomes, specifically SIRS, is not well-established.

Purpose of the Study:

• To investigate the association between operation time and the incidence of postoperative systemic inflammatory response syndrome (SIRS) in pediatric PCNL.
• To identify potential threshold effects of operation time on SIRS development.

Main Methods:

• Retrospective analysis of 472 pediatric patients undergoing PCNL.
• Multivariate logistic regression and restricted cubic spline (RCS) analysis to evaluate the relationship between operation time and SIRS.
• Subgroup analyses to explore variations in susceptibility.

Main Results:

• Postoperative SIRS occurred in 19.07% of patients.
• Increased operation time (medium and high groups) was independently associated with a higher risk of SIRS (aORs 2.63 and 2.86).
• A threshold effect was observed, with operation times exceeding 70 minutes showing a saturation effect on SIRS risk. Underweight children were more vulnerable.

Conclusions:

• Operation time is an independent risk factor for postoperative SIRS in pediatric PCNL.
• A non-linear, saturating relationship with a threshold at 70 minutes was identified.
• Findings support optimizing surgical strategies to mitigate SIRS risk in pediatric PCNL.