Mayo Adhesive Probability Score: A Reliable Predictor for Percutaneous Nephrolithotomy in Obese Patients?

Abstract

Introduction: This study evaluates the predictive value of the Mayo Adhesive Probability (MAP) score for surgical outcomes in obese patients undergoing miniaturised percutaneous nephrolithotomy (m-PCNL). The primary research question is whether the MAP score can predict intraoperative and postoperative complications in patients with a BMI greater than 30.

Methods: A retrospective analysis was conducted on patients who underwent m-PCNL at a tertiary care centre between August 2018 and August 2023. Patients with kidney stones larger than 2 cm and a BMI >30 were included. They were categorised based on MAP scores (<3 vs. ≥3). Data on operation time, fluoroscopy time, hospital stay, and complications were compared. Statistical analyses included t tests, chi-square tests, and logistic regression to assess risk factors for postoperative fever.

Results: Among 87 patients, those with a MAP score ≥3 had a significantly higher rate of postoperative fever (17.1% vs. 3.8%, p = 0.035). There were no significant differences between groups in operation time, fluoroscopy time, hospital stay, or blood transfusion needs. Logistic regression showed that a higher MAP score (OR: 6.614, p = 0.045) and increased stone burden (OR: 1.003, p = 0.040) were significant predictors of postoperative fever.

Conclusion: The MAP score is a significant predictor of postoperative fever in obese patients undergoing m-PCNL. Higher MAP scores are associated with a greater risk of fever, suggesting that careful monitoring and preventive measures are essential for patients with higher MAP scores. Further multicentre studies are needed to validate these findings and improve predictive accuracy.