Factors related to severe hemorrhage caused by percutaneous nephrolithotomy

Abstract

Objective To evaluate factors contributing to bleeding after percutaneous nephrolithotomy(PCNL) and to provide evidence for prevention and reducing severe hemorrhage caused by PCNL. Methods The medical records of 650 patients with upper urinary calculi underwent PCNL in a single center from August 2014 to August 2017 were retrospectively reviewed. Single factor chi-square test was employed to analyze the patients general characteristics(age, gender, solitary kidney, hypertension, diabetes, preoperative blood coagulation function, creatinine values, the degree of hydronephrosis, urinary tract infection), stone factors(number of stone, stone size, stone location, stone shape)and factors relative to operation(number of tract, the size of tract, calyceal access, costal entries, previous operation, and operation time). In addition, multiariable Logistic regression analysis was used to evaluate the above positive factors. Results In chi-square analysis, hypertension, diabetes, preoperative blood coagulation dysfunction, preoperative creatinine values >115 μmol/L or renal dysfunction, urinary tract infection, moderate to severe hydronephrosis, multiple kidney stones, combination of calculi in renal pelvis and calyces, multi-tracts, the larger puncture tract, repeated surgery and the operation time >90 min associate with severe hemorrhage caused by PCNL(P<0.05). In multiariable Logistic regression analysis, larger puncture tract, operation time over 90 min, urinary tract infections and renal dysfunction were independent risk factors for postoperative severe hemorrhage caused by PCNL (P<0.05). Conclusion The larger size of tract, operation time over 90 min, urinary tract infection and renal dysfunction are the independent risk factors for severe hemorrhage caused by PCNL during postoperative period. Key words: Upper urinary calculus; Percutaneous nephrolithotomy; Hemorrhage; Factors