Can Neutrophil Count, Lymhocyte Count and Neutrophil-tolymphocyte Ratio Predict Fever Following Percutaneous Nephrolithotomy in Patients Without Risk Factors?

Abstract

Objective:To examine the relationship of neutrophil counts, lymphocyte count and neutrophil-to-lymphocyte ratio (NLR) with postoperative fever in patients undergoing percutaneous nephrolithotomy (PCNL).Materials and Methods:A total of 519 patients aged over 18 years, who underwent PCNL between January 2005 and January 2013 and had a preoperative white blood cell count between 4000-12,000/μL, were included in this study. Conditions that could lead to postoperative fever or impact blood parameters constituted the exclusion criteria. At the postoperative period, the patients were divided into two groups based on the presence of fever. Age, gender, Body Mass index, stone size, number of percutaneous access, duration of operation, preoperative white blood cell count, neutrophils, lymphocytes, and NLR were compared. The relationship of these parameters with fever was evaluated with univariate and multivariate analyses.Results:The group with fever included 50 patients and the group without fever, 469 patients. The difference between the two groups was statistically significant in terms of neutrophil and lymphocyte counts, and NLR. Univariate analysis revealed that preoperative thrombocyte count, lymphocyte count, neutrophil count, and NLR were the parameterss significantly related with fever, yet, in multivariate analysis, the only statistically significant parameters related with post-PCNL fever were age, thrombocyte count, and white blood cell count.Conclusion:When risk factors for fever are excluded, lymphocyte count and NLR appear to be easy-to-use and affordable diagnostic markers to predict postoperative fever in patients undergoing PCNL.

Keywords

• bacteremia
• fever
• pcnl
• neutrophil-lymphocyte ratio