MP89-04 BODY MASS INDEX (BMI) STRATIFIED OUTCOMES OF PERCUTANEOUS NEPHROLITHOTOMY

You have accessJournal of UrologyStone Disease: Surgical Therapy VI1 Apr 2018MP89-04 BODY MASS INDEX (BMI) STRATIFIED OUTCOMES OF PERCUTANEOUS NEPHROLITHOTOMY Tim Large, Joshua M. Heiman, Blake B. Anderson, James E. Lingeman, and Amy E. Krambeck Tim LargeTim Large More articles by this author , Joshua M. HeimanJoshua M. Heiman More articles by this author , Blake B. AndersonBlake B. Anderson More articles by this author , James E. LingemanJames E. Lingeman More articles by this author , and Amy E. KrambeckAmy E. Krambeck More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2944AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Percutaneous nephrolithotomy (PCNL) is the preferred surgical approach to treat patients with large stone burdens and with complex genitourinary anatomy. Prior publications have emphasized the rising rate of obesity in the United States as well as the use of PCNL in these patients with complex stone disease. However, there is a paucity of information on risk factors of PCNL for patients with BMIs in the normal and underweight range. We hypothesize that as BMI decreases, patients are at higher risk of postoperative complications. METHODS We examined 1554 patients enrolled in our prospective, IRB-approved database, who underwent PCNL from 1999-2016. Patients were stratified into four groups based on BMI: <18.5, 18.5-25, 25-30, and 30+. Standard statistical analysis of patient demographics, perioperative course, and postoperative outcomes were compared using stata statistical software. RESULTS Of the 1,544 patients included, 317 had a BMI less than 25 with baseline characteristics, comorbidities, and postoperative course displayed in table 1. Overall, there were no differences between the groups with the exception of diabetes mellitus (DM) and hypertension (HTN) having higher prevalence in patients with BMIs greater than 25. On multivariable analysis (table 2), there was a trend toward high rates of retroperitoneal hematomas (RPH) (OR: 1.87), prolonged stenting (OR: 1.54), and need for embolization (OR: 1.89) for each decrease in a BMI category. CONCLUSIONS PCNL is feasible in patients with low BMIs. Despite the comorbidities associated with overweight and obese patients, higher BMIs seem to be protective against specific complications related to renal trauma and bleeding from PCNL. Based on this study we are able to appropriately counsel our thinner patients on their specific risk factors when planning for PCNL. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e1207 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Tim Large More articles by this author Joshua M. Heiman More articles by this author Blake B. Anderson More articles by this author James E. Lingeman More articles by this author Amy E. Krambeck More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...