Clinical Feature and Prognostic Factors of Emphysematous Pyelonephritis / 대한구급학회지
The Korean Journal of Critical Care Medicine
;
: 89-93, 2012.
Article
in Korean
| WPRIM
| ID: wpr-643769
ABSTRACT
BACKGROUND:
Emphysematous pyelonephritis (EPN) is a rare and potentially life-threatening condition that requires prompt evaluation and management. However, its clinical presentation and outcomes vary widely. This study was conducted to ascertain the clinical features and prognostic factors regarding EPN.METHODS:
All patients diagnosed with EPN radiologically and treated at the emergency department in the university-affiliated, tertiary-referral center, from January 1999 to December 2009 were evaluated. The patients' demographic and clinical characteristics, computed tomographic findings, treatment, and outcomes were analyzed retrospectively.RESULTS:
Overall 14 patients diagnosed with EPN were admitted. There were 12 females and 2 males. A history of diabetes was found in 12 (85.7%) patients and was the most common comorbidity. The chief complaint among patients was flank pain (42.9%). Severe sepsis or septic shock was noted in 10 (71.4%) patients. Thirteen cases had unilateral involvement and one case had bilateral involvement. More than half of patients had Escherichia.coli in culture. Mean serum levels of HbA1c, creatinine, C-reactive protein (CRP) were 9.4 +/- 2.7, 2.4 +/- 1.4 mg/dl, and 22.4 +/- 13.1 mg/dl. Eight (57.1%) patients received antibiotic treatment alone and four (28.6%) patients received the concurrent percutaneous drainage as well as antibiotics. Hospital mortality was 7.1%. A higher initial serum CRP level (20.3 vs. 49.8 mg/dl, p = 0.02) and HbA1c level (8.7 vs. 16.4, p = 0.01) was associated with hospital mortality.CONCLUSIONS:
Antibiotics alone provide a high success rate for the treatment of EPN. Higher serum CRP and HbA1c level was associated with a higher mortality rate in patients with EPN.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Pyelonephritis
/
Shock, Septic
/
C-Reactive Protein
/
Comorbidity
/
Drainage
/
Hospital Mortality
/
Sepsis
/
Creatinine
/
Flank Pain
/
Diabetes Mellitus
Type of study:
Prognostic study
Limits:
Female
/
Humans
/
Male
Language:
Korean
Journal:
The Korean Journal of Critical Care Medicine
Year:
2012
Type:
Article
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