MP-03.08: Predictors of blood transfusion in percutaneous nephrolithotomy (PCNL)
General Surgery (East Africa)
In the developing world with less than optimal health care facili- ties, the urologist is inundated with large volume renal calculus disease. PCNL is realized as an important modality for treat- ment. Bleeding and possible transfusion related risks remain a major concern dur- ing PCNL. This study attempts to identify factors predicting blood transfusion re- quirement in our patients undergoing this procedure.
The study period was from 1988 to May 2006. Data was collected from available records on 326 PCNLs performed in 316 patients. Two hun- dred and thirty two procedures were included in the analyses. Patient related variables studied were: Age, gender, co- morbids (Diabetes, hypertension, renal impairment, ischemic heart disease), pre operative hemoglobin, Serum Creatinine, type of stone shape, Stone burden and history of prior urinary tract infection whereas the procedure related variables included were: operative time, Stone fragmentation device used, Size of the amplatz sheath used, Numbers of punc- tures performed and the Calyx ap- proached. These were studied for asso- ciation with blood transfusion requirement using stepwise multivariate regression analysis using SPSS.
The estimated blood loss in terms of mean Hemoglobin drop was
Female gender, chronic re- nal failure, stag horn stones, and stone fragmentation with ultrasound were found to be significant factors predicting blood loss in this study.
Biyabani, S. R., Zehri, A. A., Siddiqui, K., & Memon, A. (2007). MP-03.08: Predictors of blood transfusion in percutaneous nephrolithotomy (PCNL). Urology, 70(3), 54.