Luis A. Jiménez-López, Dirección de Educación e Investigación en Salud, Unidad Médica de Alta Especialidad, Hospital de Especialidades No. 14, Centro Médico Nacional Adolfo Ruiz Cortines, Instituto Mexicano del Seguro Social, Veracruz, México
Jorge Aguilar-Morales, Departamento de Urología, Unidad Médica de Alta Especialidad, Hospital de Especialidades No. 14, Centro Médico Nacional Adolfo Ruiz Cortines, Instituto Mexicano del Seguro Social, Veracruz, México
Abel A. Ricárdez-Espinosa, Departamento de Urología, Unidad Médica de Alta Especialidad, Hospital de Especialidades No. 14, Centro Médico Nacional Adolfo Ruiz Cortines, Instituto Mexicano del Seguro Social, Veracruz, México
Jose M. Reyes-Ruiz, Departamento de Educación e Investigación. Unidad Médica de Alta especialidad No. 14 Adolfo Ruiz Cortines, Veracruz, Veracruz, México
Introduction: Blood loss is a common complication during percutaneous nephrolithotomy (PCNL), and may be severe enough to require a blood transfusion. Objective: To determine the risk factors associated with bleeding in PCNL. Method: Descriptive, retrospective, cross-sectional and observational study carried out in patients before and after undergoing PCNL in the period from August 2019 to October 2022. An analysis was performed using ROC curves. Results: Of 103 patients who underwent PCNL, 33 were men and 70 were women, and the mean age was 52.7 ±13.4 years. A total of 84 procedures were performed in supine decubitus and 19 in prone decubitus, which was related to a higher risk of bleeding (p = 0.015). The SII presented a higher AUC and specificity than the INL and LPI indexes. Regarding the complexity of the renal calculus, the CROES presented higher sensitivity and specificity when compared to the STONE classification. Conclusions: The SII and the LPI do correlate with bleeding, so they are independent risk factors for significant blood loss and can be used to predict bleeding, provided that the clinical picture is analyzed individually for each patient.
Keywords: Bleeding percutaneous. Nephrolithotomy. Systemic inflammatory index.