Is the preoperative level of procalcitonin a valid indicator for predicting postoperative fever after percutaneous nephrolithotomy?

Objective: To evaluate the risk factors for postoperative fever and to identify the value of preoperative procalcitonin (PCT) in predicting postoperative fever after percutaneous nephrolithotomy (PNL). Patients and Methods: Patients who underwent PNL between January 2014 and March 2017 were studied. In total, 363 medical records with complete data were determined to be eligible for analysis. Patients were classified into a control or febrile group according to the presence of a body temperature over 38 degrees C. Demographic and perioperative data were compared between the groups. Variables found to be statistically significant were included in a binary logistic regression analysis. Results: Ninety-one (25.1%) patients experienced postoperative fever. Univariate analysis revealed a statistically significant difference between postoperative fever and factors, such as sex (p=0.009), preoperative fever (p<0.001), stone burden (p<0.001), pyuria (p=0.013), urine culture (p<0.001), and serum levels of C-reactive protein (CRP) (p=0.003), PCT (p<0.001), and interleukin-6 (IL-6) (p=0.003). Binary logistic regression analysis indicated the presence of preoperative fever (p=0.037), stone burden >353mm(2) (p=0.002), PCT >0.05ng/mL (p<0.001), or positive urine culture (p=0.004) as independent risk factors for postoperative fever following PNL. Conclusions: We concluded that patients with preoperative fever, stone burden >353mm(2), PCT >0.05ng/mL, or positive urine culture were more likely to develop postoperative fever and that routinely detecting PCT levels before PNL would be helpful in predicting postoperative fever.