The relationship of the systemic immune inflammation index examined before the procedure with the results of the operation in adult patients who underwent percutaneous nephrolithotomy

Objective: To evaluate the relationship between the preoperative systemic immune-inflammation index and the surgical outcomes in adult patients undergoing Percutaneous Nephrolithotomy (PNL). Materials and Methods: A retrospective analysis was conducted on 824 patients who underwent PNL between January 2018 and October 2023 at the Department of Urology, Çukurova University Faculty of Medicine. Patients under the age of 18, those with kidney anomalies, and those with incomplete preoperative or postoperative data in the hospital's picture archiving and communication system were excluded from the study. Patients were grouped based on gender, age, body mass index, and the Guy's Stone Score (GSS). The relationship between the preoperative systemic immune-inflammation index (SII) and surgical outcomes such as stone-free status, need for blood transfusion, and length of hospital stay was evaluated within these groups Results : The median SII value was calculated within each group. No statistically significant relationship was found in the median SII values among the gender, BMI, and GSS groups. However, in the age group, the median SII value in the >79 years subgroup was found to be statistically significantly higher compared to other age subgroups (median SII=878) (p=0.01). When evaluating the surgical outcomes based on the median SII value, it was found that females requiring blood transfusion had a higher median SII value compared to those not requiring transfusion (median SII=726) (p=0.02). In the age group, during the evaluation of median SII and residual assessment, it was found that in the >79 years subgroup, those with CIRF had a statistically significantly higher SII value compared to those who were SF (median SII=1952) (p=0.001). In the evaluation of median SII and the need for blood transfusion within the age group, it was found that in all subgroups, those requiring blood transfusion had statistically significantly higher SII values compared to those not requiring transfusion (p=0.0001). In the BMI group, in the evaluation of median SII and the need for blood transfusion, it was observed that in the fourth group, representing the obese patient group, those with high SII had a higher need for blood transfusion, which was statistically significant (median SII=986) (p=0.001). In the GSS group, in the evaluation of median SII and the need for blood transfusion, it was found that patients in the GSS 4 group had a statistically significantly higher need for blood transfusion at higher SII values (median SII=739) (p=0.0001). The average discharge duration for all patients was 3.9±1.3 (1-14) days. A statistically significant relationship was found only in the GSS group concerning the discharge duration. As the GSS degree increased, the discharge duration also increased statistically significantly (p=0.005). In the analysis conducted with the cutoff value, a statistically significant result was obtained only in the age main group. If the patient's SII value was >820.5, it was found with a 79.7% probability (95% CI 0.73-0.86), 75% sensitivity, and 73.3% specificity that the age group was >79. In the evaluation of surgical outcomes based on the cutoff value calculation, it was found that those with lower SII values had a higher SF rate (75%); a lower need for blood transfusion (93.7%), which was statistically significant (p=0.015/p=0.006).