Preoperative albumin-globulin ratio predicts systemic inflammatory reaction after percutaneous nephrolithotomy

A retrospective review of 354 patients who had PCNL at the Guizhou Provincial People's Hospital between August 2017 and July 2019 was conducted for this purpose. The development of SIRS within 48 hours after PCNL was the study's main clinical outcome. The predictive significance of AGR for post-PCNL SIRS was confirmed using univariable and multivariable logistic regression models. To evaluate the discriminatory power of AGR with other inflammatory biomarkers, receiver operating characteristic (ROC) curves were also constructed.

Key findings of the trial:

• In 66 patients (18.64%), postoperative SIRS occurred. The patients did not get postoperative sepsis.
• According to a multivariate study, female sex, CRP, and AGR were all independently predictive factors for SIRS following PCNL (odds ratio [OR]=2.939, 95% odds ratio [OR]: 1.368- 6.315, p = 0.006, and OR = 1.008, 95% CI: 1.003-1.012, respectively).
• The AGR cut-off value of 1.145 was the most effective for predicting postoperative SIRS.
• Furthermore, AGR outperformed C-reactive protein in terms of sensitivity (83.3%), specificity (88.9%), and area under the curve (0.844). (0.808).

The authors claimed that despite all of their efforts, "a new effective and reliable indicator still demands additional investigation to further increase the sensitivity and specificity of prediction."

They came to the conclusion that patients with AGR < 1.145 should undergo rigorous evaluation and treatment prior to receiving PCNL.

REFERENCE

Wang Q, Jiang K, Chen X, Zeng G, Sun F. The Predictive Value of Preoperative Albumin–Globulin Ratio for Systemic Inflammatory Response Syndrome After Percutaneous Nephrolithotomy. Int J Gen Med. 2022;15:7407-7415

https://doi.org/10.2147/IJGM.S379741