Predictive factors of delayed bleeding after percutaneous nephrolithotomy requiring angioembolization

Abstract

Abstract Objectives To investigate the predictive factors of delayed post‐percutaneous nephrolithotomy (PCNL) haemorrhage because of arteriovenous fistula (AVF) or pseudoaneurysm (PA) and compare the factors between AVF and PA. Patients and methods This is a case–control study with a case‐to‐control ratio of 1:3. Out of 5077 patients who underwent PCNL from April 2015 to April 2018 in three different teaching hospitals, 113 had post‐PCNL haemorrhages because of AVF and/or PA. Seventy‐two patients met the inclusion criteria and entered the study as cases, while 216 patients without any postoperative complications were selected as controls. Results Of all 72 studied patients with complications after PCNL, 35 (48.6%) had AVF, and the rest had PA. The regression model revealed that a history of diabetes (odds ratio [OR]: 2.799, 95% confidence interval [CI]: 1.392–5.630, p‐value = 0.004) and renal anomalies (OR: 2.929, 95% CI: 1.108–7.744, p‐value = 0.03) were associated with developing delayed post‐PCNL haemorrhage. However, no differences were seen between AVF and PA regarding selected variables (p‐value > 0.05). Conclusion History of diabetes and renal anomalies were predictive factors for delayed post‐PCNL haemorrhage, but no predictive factors were found to differentiate PA and AVF from one another.

Keywords

• arteriovenous fistula
• percutaneous nephrolithotomy
• postoperative complications
• postoperative haemorrhage
• pseudoaneurysm