Emergency Drainage for Urosepsis Associated With Upper Urinary Tract Calculi

Yoshimura, Koji; Utsunomiya, Noriaki; Ichioka, Kentaro; Ueda, Nobufumi; Matsui, Yoshiyuki; Terai, Akito

doi:10.1097/01.ju.0000150512.40102.bb

Cited by 97 publications

(93 citation statements)

References 14 publications

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“…Original articles and their references were checked, and articles about pyelonephritis in pregnant or infant patients were excluded. Data from eight clinical studies discussing predictive factors for severe conditions and mortality in patients with acute obstructive pyelonephritis were summarized (Table 1) [6][7][8][9][10][11][12][13].…”

Section: Methodsmentioning

confidence: 99%

“…The need for intensive management was reported as a severe outcome in another study [10]. Two studies evaluated risk factors for emergency drainage in calculous pyelonephritis [9,10], and risk factors for mortality were assessed in two studies [12,13].…”

Section: Patients and Definitions Of Severe Conditionsmentioning

confidence: 99%

“…Of the seven single-institutional studies, five included only obstructive pyelonephritis with upper urinary tract calculi and one included obstructive pyelonephritis with any causes [6][7][8][9][10][11], and the other study targeted severe acute pyelonephritis and included non-obstructive cases [12].…”

Section: Patients and Definitions Of Severe Conditionsmentioning

confidence: 99%

“…Systemic inflammatory response syndrome (SIRS) includes two or more of the following conditions: 1) body temperature higher than 38 o C or lower than 36 o C, 2) heart rate greater than 90 beats per minute, 3) tachypnea, as manifested by a respiratory rate greater than 20 breaths per minute or hyperventilation, as indicated by a partial CO 2 pressure less than 32 mmHg, and 4) white blood cell count greater than 12,000/mm 3 or less than 4,000/mm 3 , or more than 10% immature neutrophils, and SIRS is often used as the diagnosis of sepsis [15]. Of eight studies summarized in this study, four studies adopted SIRS as the definition of sepsis [7,[9][10][11], while the definitions of systemic inflammation response to infection were not specific or mentioned in the other four studies [6,8,12,13]. Severe sepsis and septic shock are generally defined as sepsis complicated by acute organ dysfunction and sepsis with acute circulatory failure characterized by persistent arterial hypotension despite adequate volume resuscitation, respectively [14].…”

Section: Definitions Of Sepsis Severe Sepsis and Septic Shockmentioning

confidence: 99%

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What Are the Predictive Factors of Severe Conditions in Acute Obstructive Pyelonephritis?

Kamei

Homma

2016

Urogenit Tract Infect

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Acute obstructive pyelonephritis is a common urological infection, often requiring emergency drainage, which shows rapid progression to serious conditions, including severe sepsis or septic shock. Therefore, during an initial evaluation, knowledge of factors for prediction of severe conditions or mortality is important for immediate identification of patients requiring intensive care. Previous studies examining the characteristics of patients with acute obstructive or calculous pyelonephritis reported rates of septic shock and mortality of 20.8-33.3% and 0-7.4%, respectively. Thrombocytopenia, older age, low serum albumin, and bacteremia were relatively common predictors for septic shock. In contrast, age over 80 years, systemic inflammatory response syndrome, disseminated intravascular coagulation status, disturbance of consciousness, male gender, and having only one kidney were predictive factors for mortality.

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Section: Methodsmentioning

confidence: 99%

Section: Patients and Definitions Of Severe Conditionsmentioning

confidence: 99%

Section: Patients and Definitions Of Severe Conditionsmentioning

confidence: 99%

Section: Definitions Of Sepsis Severe Sepsis and Septic Shockmentioning

confidence: 99%

See 2 more Smart Citations

What Are the Predictive Factors of Severe Conditions in Acute Obstructive Pyelonephritis?

Kamei

Homma

2016

Urogenit Tract Infect

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“…It is an emergent urological condition that can cause septicemia with increased risk of mortality [1,2]. About 10% of patients with septic shock due to UTI had an accompanying condition of urinary tract obstruction (UTO).…”

Section: Introductionmentioning

confidence: 99%

The Risk Factors of Recurrent Febrile Urinary Tract Infection within 1 Year in Urinary Stone Patients with Acute Obstructive Pyelonephritis

Lee

Yoon

et al. 2017

Urogenit Tract Infect

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Purpose: To identify and evaluate the risk factors for the development of recurrent febrile urinary tract infection (fUTI) among patients with previous urinary stone and acute obstructive pyelonephritis (OPN). Materials and Methods:We retrospectively reviewed the medical records of 52 patients, who had urinary tract stones presented with OPN, between 2010 and 2015. Following their initial treatment, patients who were subsequently admitted with fUTI were included. Results: The mean age of patients was 62.2±14.6 years, and the mean follow-up duration was 26.0±20.39 months. Escherichia coli was found to be the dominating organism (68.2%, 15/22) in the initial urine culture. Patients were divided into two groups: The recurrent fUTI group (n=23) and the non-recurrent fUTI group (n=29). Between these two groups, significant differences were found with respect to diabetes history (recurrent group: 47.8% vs. non-recurrent group; 17.2%, p=0.018), stone location (kidney, 60.9% vs. ureter, 31.0%, p=0.031), and initially positive urine culture (60.9% vs. 27.6%, p=0.016). In a multivariate analysis, having an initially positive urine culture (95% confidence interval, 1.130-224.117; p=0.040) was identified as being an independent risk factor for developing recurrent fUTI. In a multivariate analysis, the initial laboratory test finding of acute renal insufficiency (ARI, p=0.019) and presence of a kidney stone (p=0.022) were significant factors associated with a newly-diagnosed-positive urine culture diagnosis. Conclusions: Having an initially positive urine culture was a significant risk factor for the development of recurrent fUTI in urinary stone patients with acute OPN. In addition, repeated urine tests were also needed in patients with ARI or renal stones during the follow-up period.

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Emergency Urinary Drainage Techniques Employed for an Obstructing Upper Urinary Tract Calculus With and Without Associated Sepsis

Mathur¹,

Keeley²

2014

Urinary Stones

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Emergency Drainage for Urosepsis Associated With Upper Urinary Tract Calculi

Cited by 97 publications

References 14 publications

What Are the Predictive Factors of Severe Conditions in Acute Obstructive Pyelonephritis?

What Are the Predictive Factors of Severe Conditions in Acute Obstructive Pyelonephritis?

The Risk Factors of Recurrent Febrile Urinary Tract Infection within 1 Year in Urinary Stone Patients with Acute Obstructive Pyelonephritis

Emergency Urinary Drainage Techniques Employed for an Obstructing Upper Urinary Tract Calculus With and Without Associated Sepsis

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