Can neutrophil / lymphocyte ratio be used a predictive parameters of infective complications occurring in early postoperative period after percutaneous nephrolithotomy?

Aim: It is planned to investigate the predictive value of neutrophil / lymphocyte ratio in evaluation and treatment planning of infective complications in early postoperative period after percutaneous nephrolithotomy. Materials and Methods: The results of 335 patients who underwent percutaneous nephrolithotomy (PNL) treatment in Celal Bayar University Hospital Department of Urology and Bozyaka Training and Research Hospital Department of Urology between January 2012 and January 2016 were retrospectively evaluated Patients who had positive urine culture results and patients whose antibiotic changes were followed were analyzed for neutrophil lymphocyte ratios. These patients were compared in terms of postoperative infectious complication predicting results by looking at the neutrophil / lymphocyte ratio. Retrospectively documented patient data were divided into subgroups and analyzed by SPSS program using regression analysis, Mann-Whitney U test, ROC analysis, Youden index method and chi-square test. Results: Median NLR was calculated as 2.4 (0.66-45.6) in patients without postoperative sepsis and 4.48 (1-33.14) in patients with postoperative sepsis. Median NLR values of patients with and without postoperative sepsis were significantly different (p = 0.026). The area under the curve for postoperative sepsis was calculated as 0.697 (p = 0.026). Sensitivity was calculated as 81.8% and specificity was 51.9% for NLR≥2.495 threshold value. The area under the curve for postop sepsis was calculated as 0.697 (p = 0.026). Sensitivity was calculated as 81.8% and specificity was 51.9% for NLR≥2.495 threshold value. Conclusion: In our study, NLR was found to be predictive of positive preoperative urine culture, positive postoperative urine culture, intrarenal pelvic culture, post-operative fever, and post-operative sepsis. In the case of NLR ≥2.495, the risk of post operative sepsis can be reduced to minimum with wide spectrum antibiotherapy. Keywords: kidney stones, percutaneous nephrolithotomy, sepsis, neutrophil lymphocyte ratio