The Predictive Value of Preoperative Albumin-Globulin Ratio for Systemic Inflammatory Response Syndrome After Percutaneous Nephrolithotomy

Purpose: This study aimed to assess the predictive value of preoperative albumin-globulin ratio (AGR) for systemic inflammatory response syndrome (SIRS) after percutaneous nephrolithotomy (PCNL).Methods: Patients who underwent PCNL in Guizhou Provincial People's hospital between August 2017 and July 2019 were enrolled and retrospectively reviewed. The primary clinical outcome of the current study was the development of SIRS within 48h after PCNL. Univariable and multivariable logistic regression analyses were conducted to verify the predictive value of AGR for post-PCNL SIRS. In addition, receiver operating characteristic (ROC) curves were generated to compare the discriminatory ability of AGR with other inflammatory biomarkers.Results: 354 patients who underwent PCNL were enrolled and 66 patients (18.64%) developed postoperative SIRS. None of the patients suffered postoperative sepsis in our study. Multivariate analysis demonstrated that female sex (odds ratio [OR]=2.939, 95% odds ratio [OR]: 1.368-6.315, p = 0.006), CRP (OR = 1.008, 95% CI: 1.003-1.012, p = 0.001), and AGR (OR = 0.048, 95% CI: 0.010-0.239, p < 0.001) were all independent predictors for SIRS after PCNL. The optimal cut-off value of AGR for predicting postoperative SIRS was 1.145. In addition, AGR had a higher area under the curve (0.844) with sensitivity of 83.3% and specificity of 88.9% than C-reactive protein (0.808).Conclusion: Preoperative AGR is a potential predictor for SIRS development after PCNL.