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Erschienen in: Abdominal Radiology 2/2021

28.08.2020 | Kidneys, Ureters, Bladder, Retroperitoneum

Clinical and computed tomography factors associated with sepsis in women with clinically uncomplicated pyelonephritis

verfasst von: Young Rock Jang, Su Joa Ahn, Seung Joon Choi, Joong Sik Eom, Yong Kyun Cho, Young Sup Shim, So Hyun Park, Jeong Ho Kim, Hyung-Sik Kim

Erschienen in: Abdominal Radiology | Ausgabe 2/2021

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Abstract

Objective

Sepsis is major determinants of prognosis in acute pyelonephritis (APN). This study aimed to assess factors associated with the development of sepsis among patients with clinically uncomplicated APN.

Subjects and methods

We examined 463 patients presenting to our hospital without complications. We assessed clinical factors including demographic and laboratory features. Renal and extrarenal features on computed tomography (CT) were also analyzed. Risk factors of sepsis are assessed.

Results

The study included 361 patients without (78.0%) and 102 patients with sepsis (22.0%). Crude and attributable mortality rates were 3.9% and 2.0% versus 1.4% and 0.6%, respectively, among patients with and without sepsis. Clinical risk factors for sepsis were age >65 years (odds ratio [OR] 1.79, P = 0.02), absence of flank pain (OR 1.59, P = 0.04), absence of costovertebral tenderness (OR 1.89, P = 0.03), diabetes mellitus (OR 2.25, P = 0.02), bacteremia (OR 2.8, P = 0.01), C-reactive protein level >100 mg/L (OR 1.42, P = 0.02), and lack of previous APN history (OR 1.76, P = 0.04). APN grade IV (OR 3.16, P = 0.01), high grade hydronephrosis (OR 1.50, P = 0.03), diffuse peritoneal thickening (OR 4.12, P = 0.01), and acute interstitial pulmonary edema (OR 3.73, P = 0.01) were the CT features predictive of septic shock.

Conclusions

Although uncomplicated APN was largely non-fatal, several clinical and CT features could lead to sepsis. Our findings may be useful for predicting sepsis risk and deciding whether intravenous antibiotic treatment and intensive management should be initiated for uncomplicated APN.
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Metadaten
Titel
Clinical and computed tomography factors associated with sepsis in women with clinically uncomplicated pyelonephritis
verfasst von
Young Rock Jang
Su Joa Ahn
Seung Joon Choi
Joong Sik Eom
Yong Kyun Cho
Young Sup Shim
So Hyun Park
Jeong Ho Kim
Hyung-Sik Kim
Publikationsdatum
28.08.2020
Verlag
Springer US
Erschienen in
Abdominal Radiology / Ausgabe 2/2021
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-020-02711-3

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