Bleeding and Fever after Pediatric Mini-Percutaneous Nephrolithotomy: Is the Mayo Adhesive Probability Score a Reliable Predictor?

Abstract

Purpose:

This study aimed to evaluate the role of the Mayo adhesive probability (MAP) score in predicting intraoperative and postoperative complications in pediatric patients undergoing mini-percutaneous nephrolithotomy (mPCNL).

Materials and Methods:

Fifty-three pediatric patients who underwent mPCNL between January 2019 and November 2024 were retrospectively analyzed. Patients were divided into two groups based on MAP scores (<3 and ≥3). Demographic, clinical, laboratory, and radiological data, as well as intraoperative and postoperative complications, were compared.

Results:

The mean age was 9.9 ± 4.9 years. Thirty-one patients (58.4%) were in the group with MAP scores <3, whereas 22 patients (41.5%) were in the group with MAP scores ≥3. Intraoperative hemoglobin drop was significantly higher in patients with MAP scores ≥3 (p = 0.003). The transfusion rate and Clavien–Dindo (CD) ≥3 complication rate were significantly higher in the MAP ≥3 group (p = 0.037, p = 0.016, respectively). In contrast, the postoperative fever rate and readmission rate were not associated with MAP score, and no significant differences were observed between the groups.

Conclusion:

The MAP score has predictive value for hemoglobin drop, transfusion requirement, and severe postoperative complications (CD ≥3) in pediatric mPCNL cases. Therefore, surgeons can use the MAP score in preoperative risk assessments to implement the necessary precautions to prevent complications.