Background: Systemic inflammatory response syndrome (SIRS) and sepsis are major complications following percutaneous nephrolithotomy (PNL). Early detection remains difficult due to nonspecific clinical presentation. This study aimed to evaluate neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) for predicting SIRS and sepsis after PNL.
Methods: Adult patients undergoing PNL at a tertiary center were analyzed. NLR, PLR, and LMR were calculated from preoperative blood counts. SIRS was defined based on standard clinical criteria, while sepsis was defined as SIRS with confirmed infection. Associations between inflammatory markers and outcomes were evaluated, and cut-off values were determined using ROC analysis.
Results: SIRS occurred in a proportion of patients, with a smaller subset developing sepsis. SIRS was associated with higher NLR, higher PLR, and lower LMR (all p<0.05). NLR showed strong predictive value, with a cut-off around 2.03. PLR (>110.62) and LMR (<3.23) were also significantly associated with SIRS.
Conclusion: NLR, PLR, and LMR were significantly associated with SIRS and sepsis following PNL. NLR is simple and rapidly obtainable, while PLR and LMR provide additional inflammatory stratification. These markers may support early identification of high-risk patients.1–4