ArticleFrontiers in nutrition2026
Risk stratification of composite adverse outcomes after percutaneous nephrolithotomy based on preoperative inflammatory-nutritional status and stone complexity: a single-center retrospective study.
Article in Frontiers in nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To investigate the predictive value of preoperative inflammatory-nutritional status and stone complexity for composite adverse outcomes following percutaneous nephrolithotomy (PCNL), and to develop a clinical risk stratification model. Methods: Clinical data of 386 patients with renal calculi who underwent PCNL at the Cangzhou Central Hospital between January 2021 and December 2024 were retrospectively analyzed. Composite adverse outcomes were defined as the occurrence of any of the following: postoperative fever (temperature >38 °C), systemic inflammatory response syndrome (SIRS), requirement for blood transfusion, or complications of Clavien-Dindo grade ≥ II. Preoperative inflammatory-nutritional status was assessed using the neutrophil-to-lymphocyte ratio (NLR) and prognostic nutritional index (PNI), while stone complexity was quantified using the Guy's grading system and the S. T. O. N. E. nephrolithometry score. Multivariate logistic regression analysis was performed to identify independent risk factors, and a risk stratification model was constructed based on the number of these factors. Results: Among the 386 patients, 121 (31.3%) experienced composite adverse outcomes postoperatively. Multivariate logistic regression analysis identified diabetes mellitus (OR = 2.41, 95% CI: 1.32-4.41, Conclusion: Preoperative inflammatory-nutritional status (NLR, PNI) and stone complexity (Guy's grading system, S. T. O. N. E. score) are independent predictors of composite adverse outcomes after PCNL. The risk stratification model based on the number of risk factors is simple and reliable, and can effectively identify high-risk patients, providing a basis for precise perioperative management.
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