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Introduction: Postoperative Systemic Inflammatory Response Syndrome (SIRS) may be considered an ominous sign. Anecdotally, SIRS is often observed in the otherwise well patient following percutaneous nephrolithotomy (PCNL). We sought to evaluate if SIRS following PCNL is predictive of unplanned 90 day readmission.
Materials & Methods: We retrospectively reviewed consecutive patients undergoing PCNL in two dedicated endourologic practices. Patient characteristics collected included demographics and surgical characteristics. SIRS was defined as having two or more of the following: max white blood cell count >12,000, temperature>38 degrees Celsius, heart rate >90, and respiratory rate >20 within the first 24hrs following PCNL. Chi square analysis was used to compare readmission rates between SIRS and non-SIRS groups.
Results: We identified 382 patients undergoing PCNL, 42% (162/382) that met criteria for SIRS within 24hrs of PCNL. Overall, readmission within 90 days was required in 7.1 % (27/382). Reasons for readmission included urosepsis (6/382), UTI (4/382), pneumonia (4/382), AKI (3/382), blood transfusion (1/382), and other non-related medical issues (9/382). Perioperative SIRS was not associated with readmission, with 3.7% of the SIRS patients requiring readmission for UTI or urosepsis compared with 1.8% without SIRS, (p=0.335).
Conclusions: Nearly half of patients undergoing PCNL met criteria for SIRS. Although an ominous prognosticator in other settings, there was no significant correlation between SIRS and 90 day readmission in the postoperative PCNL patient. This may indicate that patient developing SIRS immediately following PCNL may be otherwise safely discharged without increased likelihood of readmission.