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. 2024 May 31;52(1):80.
doi: 10.1007/s00240-024-01586-z.

The mayo adhesive probability score predicts postoperative fever and sepsis in retrograde intrarenal surgery

Tsung-Yi Hsieh  1 , Shang-Jen Chang  1 , Jeff Shih-Chieh Chueh  1 , Yuan-Ju Lee  2
Affiliations

The mayo adhesive probability score predicts postoperative fever and sepsis in retrograde intrarenal surgery

Tsung-Yi Hsieh et al. Urolithiasis. .

Abstract

Infectious complications are among the most common and potentially life-threatening morbidities of retrograde intrarenal surgery (RIRS). Few predictive tools on these complications include radiological signs. The Mayo adhesive probability (MAP) score is an image-based scoring system that incorporates two radiological signs: perinephric fat stranding and perinephric fat thickness. Previous studies have suggested an association between these signs and febrile urinary tract infection (UTI) following lithotripsy. This study aimed to evaluate the predictive factors, including the MAP score, for post-RIRS fever and sepsis. A total of 260 patients who underwent 306 RIRS between October 2019 to December 2023 due to renal or upper ureteral stones were included in this retrospective study. Patient demographics, perioperative characteristics, stone factors, radiological signs, and MAP scores were recorded. Multivariate logistic regression analysis was used to evaluate the risk factors associated with postoperative fever and sepsis. Postoperative fever and sepsis occurred in 20.8% and 8.5% of the patients, respectively. On multivariate analysis, female gender, history of recurrent UTI, larger maximal stone diameter, and higher MAP score were independent risk factors for postoperative fever and sepsis. Identifying the risk factors for post-RIRS infectious complications is imperative to providing the proper perioperative management. The MAP score is a promising, easily calculated, image-based scoring system that predicts post-RIRS fever and sepsis.

Keywords: Mayo adhesive probability score; Postoperative complications; Retrograde intrarenal surgery; Sepsis; Urinary tract infection; Urolithiasis.

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Conflict of interest statement

The authors declare no conflict of interest in this study. The authors have no relevant financial or non-financial interests to disclose. This study was reviewed and approved by the Research Ethics Committee of the National Taiwan University Hospital. The study is retrospective in nature and does not involve ongoing human subject studies. Formal consent is not required for this retrospective review.

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Mayo adhesive probability (MAP) score (a) MAP score = 0. The fat around the kidney demonstrates no stranding. The posterior perinephric fat thickness is < 1 cm. (b) MAP score = 3. The fat around the kidney has some image-dense stranding present but no thick bars of inflammation. The posterior perinephric fat thickness is 1.1–1.9 cm. (c) MAP score = 5. The fat around the kidney shows severe stranding around the kidney with thick image-dense bars of inflammation. The posterior perinephric fat thickness is > 2 cm
See this image and copyright information in PMC

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