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Objective <p>This study aimed to investigate the predictive value of the Region of Interest (ROI)-modified Mayo Adhesive Probability (MAP) score for postoperative fever following percutaneous nephrolithotomy (PCNL) and to compare its diagnostic accuracy with the conventional MAP score.</p> Materials and Methods <p>A total of 306 patients who underwent mini-PCNL between January 2019 and December 2024 were retrospectively analyzed. The original MAP score incorporated posterior perinephric fat thickness and visually graded fat stranding, whereas the ROI-modified MAP score replaced the subjective stranding component with an objective quantification of perinephric fat density in Hounsfield Units (HU). Demographic, stone-related, and operative parameters were evaluated. Predictors of postoperative fever were analyzed using univariate and multivariate logistic regression models.</p> Results <p>Postoperative fever occurred in 9.8% of patients. In multivariate analysis, diabetes mellitus (OR = 2.39, 95% CI 1.01–5.66, <i>p</i> = 0.047) and MAP ≥ 3 (OR = 2.82, 95% CI 1.19–6.68, <i>p</i> = 0.019) were independent predictors. When the ROI-modified MAP score was used, only ROI-MAP ≥ 3 remained significant (OR = 2.73, 95% CI 1.82–4.12, <i>p</i> &lt; 0.001). The ROI-modified MAP demonstrated superior predictive accuracy (AUC = 0.759) compared with the conventional MAP (AUC = 0.612), with a significant difference confirmed by DeLong’s test (<i>p</i> = 0.013).</p> Conclusion <p>The ROI-modified MAP score provides an objective, quantitative method for assessing perinephric fat and demonstrates superior accuracy in predicting postoperative fever after PCNL. It may serve as a practical tool for preoperative risk stratification and help identify patients who may benefit from closer perioperative monitoring for postoperative infectious complications.</p>

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The ROI-modified mayo adhesive probability score as a predictor of postoperative fever after mini-PCNL

  • 期刊论文

  • 发表日期：

    2026年2月12日

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  • Oguzhan Yildiz,
  • Huseyin B. Yazili,
  • Seyit B. Ari,
  • Ufuk Caglar,
  • Faruk Ozgor,
  • Omer Sarilar

摘要

Objective

This study aimed to investigate the predictive value of the Region of Interest (ROI)-modified Mayo Adhesive Probability (MAP) score for postoperative fever following percutaneous nephrolithotomy (PCNL) and to compare its diagnostic accuracy with the conventional MAP score.

Materials and Methods

A total of 306 patients who underwent mini-PCNL between January 2019 and December 2024 were retrospectively analyzed. The original MAP score incorporated posterior perinephric fat thickness and visually graded fat stranding, whereas the ROI-modified MAP score replaced the subjective stranding component with an objective quantification of perinephric fat density in Hounsfield Units (HU). Demographic, stone-related, and operative parameters were evaluated. Predictors of postoperative fever were analyzed using univariate and multivariate logistic regression models.

Results

Postoperative fever occurred in 9.8% of patients. In multivariate analysis, diabetes mellitus (OR = 2.39, 95% CI 1.01–5.66, p = 0.047) and MAP ≥ 3 (OR = 2.82, 95% CI 1.19–6.68, p = 0.019) were independent predictors. When the ROI-modified MAP score was used, only ROI-MAP ≥ 3 remained significant (OR = 2.73, 95% CI 1.82–4.12, p < 0.001). The ROI-modified MAP demonstrated superior predictive accuracy (AUC = 0.759) compared with the conventional MAP (AUC = 0.612), with a significant difference confirmed by DeLong’s test (p = 0.013).

Conclusion

The ROI-modified MAP score provides an objective, quantitative method for assessing perinephric fat and demonstrates superior accuracy in predicting postoperative fever after PCNL. It may serve as a practical tool for preoperative risk stratification and help identify patients who may benefit from closer perioperative monitoring for postoperative infectious complications.