Predictive Factors for Post-Operative Bleeding in Percutaneous Nephrolithotomy.

Abstract

Introduction: Post-operative bleeding is a serious complication necessitating prompt attention inPercutaneous Nephrolithotomy (PCNL). A number of factors dictate the severity of post-PCNL bleeding.Identification of these risk factors helps prevent bleeding complications. Methods: In this observationalcross-sectional study, a total of 126 patients with renal stones >10mm or stag-horn stones underwent PCNL.All the relevant pre- and intra-operative factors were noted and analyzed. Hemoglobin differences betweenpre- and post-operative levels were considered for the evaluation of blood loss. Univariate and multivariablelogistic regression analysis was done. The strength of association was examined using Odds Ratio and95% confidence intervals derived from the logistic regression. A p value <0.05 was considered statisticallysignificant. Results: The mean age of the patients was 31.9 ±4.47 years. The mean drop in hemoglobinwas 1.83 ±0.98 gm/dl. Age, stone size, number of tracts, size of Amplatz sheath and number of stonessignificantly affected the blood loss in univariate analysis. Among the variables mentioned above only, thenumber of stones could maintain the significance in multivariable analysis (p<0.05). The number of stonesincrease the risk of bleeding post PCNL by 4.4 times. Conclusion: Stone size, number of tracts, size ofAmplatz sheath and the number of stones significantly affect the blood loss post PCNL. Identification ofthese risk factors should be considered for minimizing bleeding in PCNL.