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.

1.
Gogas Yavuz
D
,
Akhtar
O
,
Low
K
,
Gras
A
,
Gurser
B
,
Yilmaz
ES
, et al
.
The economic impact of obesity in Turkey: a micro-costing analysis
.
Clinicoecon Outcomes Res
.
2024
;
16
:
123
32
.
2.
World Health Organization
.
Obesity and overweight
.
2023
. Retrieved from WHO website.
3.
Abarca-Gómez
L
,
Abdeen
ZA
,
Hamid
ZA
,
Abu-Rmeileh
NM
,
Acosta-Cazares
B
,
Acuin
C
, et al
.
Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults
.
Lancet
.
2017
;
390
(
10113
):
2627
42
.
4.
Türk
C
,
Petřík
A
,
Sarica
K
,
Seitz
C
,
Skolarikos
A
,
Straub
M
, et al
.
EAU guidelines on diagnosis and conservative management of urolithiasis
.
Eur Urol
.
2016
;
69
(
3
):
468
74
.
5.
Akman
T
,
Binbay
M
,
Sari
E
,
Yuruk
E
,
Tepeler
A
,
Akcay
M
, et al
.
Factors affecting bleeding during percutaneous nephrolithotomy: single surgeon experience
.
J Endourol
.
2011
;
25
(
2
):
327
33
.
6.
de la Rosette
JJ
,
Zuazu
JR
,
Tsakiris
P
.
Prognostic factors and perioperative morbidity in percutaneous nephrolithotomy: a prospective multicenter study
.
Eur Urol
.
2009
;
55
(
5
):
1235
45
.
7.
Bier
S
,
Aufderklamm
S
,
Todenhöfer
T
,
Kruck
S
,
Schuster
K
,
Rausch
S
, et al
.
Prediction of postoperative risks in laparoscopic partial nephrectomy using RENAL, Mayo adhesive probability and renal pelvic score
.
Anticancer Res
.
2017
;
37
(
3
):
1369
73
.
8.
Haberal
HB
,
Ayvaz
S
,
Kilicalp
AS
,
Sadioglu
FE
,
Senocak
C
,
Bozkurt
OF
.
Is the Mayo adhesive probability score predictive in patients undergoing percutaneous nephrolithotomy
.
J Laparoendosc Adv Surg Tech
.
2024
;
34
(
3
):
251
6
.
9.
Yanishi
M
,
Kinoshita
H
,
Koito
Y
,
Taniguchi
H
,
Mishima
T
,
Sugi
M
, et al
.
Adherent perinephric fat is a surgical risk factor in laparoscopic single-site donor nephrectomy: analysis using Mayo adhesive probability score
.
Transpl Proc
.
2020
;
52
(
1
):
84
8
.
10.
Franquet
Q
,
Matillon
X
,
Terrier
N
,
Rambeaud
JJ
,
Crouzet
S
,
Long
JA
, et al
.
The Mayo adhesive probability score can help predict intra- and postoperative complications in patients undergoing laparoscopic donor nephrectomy
.
World J Urol
.
2021
;
39
(
7
):
2775
81
.
11.
Chen
WA
,
Huang
HS
,
Lu
ZH
,
Liu
CJ
.
The Mayo adhesive probability score predicts postoperative fever and intraoperative hemorrhage in mini-percutaneous nephrolithotomy
.
World J Urol
.
2023
;
41
(
9
):
2503
9
.
12.
Hsieh
TY
,
Chang
SJ
,
Chueh
JS
,
Lee
YJ
.
The Mayo adhesive probability score predicts postoperative fever and sepsis in retrograde intrarenal surgery
.
Urolithiasis
.
2024
;
52
(
1
):
80
.
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