TY - JOUR
T1 - Tasa libre de litos sin complicación mayor como definición de éxito en nefrolitotomía percutánea
AU - Moreno-Palacios, Jorge
AU - Avilés-Ibarra, Oswaldo José
AU - López-Samano, Virgilio Augusto
AU - Rivas-Ruiz, Rodolfo
AU - Rodríguez-Silverio, Juan
AU - Maldonado-Alcaraz, Efraín
N1 - Publisher Copyright:
© 2019, Academia Nacional de Medicina. All rights reserved.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Introduction: Success in percutaneous nephrolithotomy (PCNL) is defined as a stone-free status; however, major complications are highly common and have been reported as a secondary outcome. Objective: To propose a new definition of PCNL success that comprises a stone free rate without major complications and a risk scale to predict this outcome. Methods: Historical cohort of patients undergoing PCNL. The included variables were age, gender, urine culture, Charlson’s comorbidity index (CCI) and complex stones. Success was defined as a stone free status with or without Clavien grade = 2 complication; intermediate success: with stones, with or without Clavien grade = 2 complication; and failure: with or without stones with Clavien grade = 2 complication. Bivariate analysis was performed to identify which factors are associated with the outcome. The independent weight of each factor was calculated by multiple logistic regression analysis. Results: 568 procedures were included, 59% of which were in females. Median age was 49 years; 65%, 22% and 13% of cases were classified as success, intermediate success and failure, respectively. Female sex, positive urine culture, complex stones and severe CCI were associated with failure. Conclusions: The likelihood of success was directly proportional to the number of risk factors.
AB - Introduction: Success in percutaneous nephrolithotomy (PCNL) is defined as a stone-free status; however, major complications are highly common and have been reported as a secondary outcome. Objective: To propose a new definition of PCNL success that comprises a stone free rate without major complications and a risk scale to predict this outcome. Methods: Historical cohort of patients undergoing PCNL. The included variables were age, gender, urine culture, Charlson’s comorbidity index (CCI) and complex stones. Success was defined as a stone free status with or without Clavien grade = 2 complication; intermediate success: with stones, with or without Clavien grade = 2 complication; and failure: with or without stones with Clavien grade = 2 complication. Bivariate analysis was performed to identify which factors are associated with the outcome. The independent weight of each factor was calculated by multiple logistic regression analysis. Results: 568 procedures were included, 59% of which were in females. Median age was 49 years; 65%, 22% and 13% of cases were classified as success, intermediate success and failure, respectively. Female sex, positive urine culture, complex stones and severe CCI were associated with failure. Conclusions: The likelihood of success was directly proportional to the number of risk factors.
KW - Kidney calculi
KW - Percutaneous nephrolithotomy
KW - Postoperative complications
KW - Risk factor
KW - Treatment outcomes
UR - http://www.scopus.com/inward/record.url?scp=85062062392&partnerID=8YFLogxK
U2 - 10.24875/GMM 18004474
DO - 10.24875/GMM 18004474
M3 - Artículo
C2 - 30799454
AN - SCOPUS:85062062392
SN - 0016-3813
VL - 155
SP - 52
EP - 57
JO - Gaceta Medica de Mexico
JF - Gaceta Medica de Mexico
IS - 1
ER -