Clinical, biochemical and microbiological determinants in the clinical course of patients with emphysematous pyelonephritis: A case series of 43 patients in a single hospital in Mexico

Lumbreras, Eva; J, Ramirez; Patiño, Jennifer; Lopez, Boryana; García, José Fernando Gil; Ordaz, O. Morales; Pedraza, H. Lujano; J, Colin

doi:10.1016/s1569-9056(18)31173-4

Cited by 2 publications

(1 citation statement)

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“…Unlike other series that found that bacteria type could influence EPN severity, with especially Klebsiella infection 14 , the type of organism was not a risk factor of severity of mortality. Radiologically, Huang and Tseng described in 2000 four distinct radiological classifications of EPN based on the extent of gas seen on CT 4 .…”

Section: Discussioncontrasting

confidence: 87%

Risk factors for sepsis and mortality in patients with emphysematous pyelonephritis : a series of 68 cases (case series)

Bedoui,

Saadi,

Zaghbib

et al. 2023

Annals of Medicine &Amp; Surgery

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Background: Emphysematous pyelonephritis (EPN) is a rare and severe necrotizing infection of the kidney with a high rate of complications and mortality. Our aim was to investigate risk factors of urosepsis and mortality in case of EPN. Materials and Methods: Between January 2010 and December 2022 the charts of patients diagnosed with EPN were retrospectively reviewed. Patients medical records were collected and data including demographics, Body Mass Index (BMI), EPN type, the organism causing infection and biochemical variables were registered. We performed an univariate and multivariate logistic regression analysis for sepsis, septic shock and mortality. Statistical significance was defined as a p value of < 0.05. Results: Our study included 68 patients (63% females, mean age 58.6 years old). Forty-eight patients (70.6%) had Diabetes. Half of the patients (50%) presented with sepsis and 11 patients (16.2%) developed a septic shock. The following factors were associated with sepsis by univariate analysis : diabetes (P=0.01), higher blood sugar on admission (P=0.01), higher leucocytic count (P<0.001), higher lymphocytic count (P<0.001) and lower PLR (P<0.001). Multivariate regression analysis revealed that the main risk factors of urosepsis were the leukocytic (OR:85.7 ; IC 95% : 9.177–800.486 ; P<0.001) and lymphocytic count (OR:6.65 ; IC 95% : 1.228–36.050 ; P=0.028). Neither of variables was significantly associated with higher risk of mortality. Conclusion: Leucocytic and lymphocytic count on admission are independent simple predictors for sepsis in patients with EPN.

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Section: Discussioncontrasting

confidence: 87%