Risk factors of septic shock in bacteremic acute pyelonephritis patients admitted to an ER

Lee, Jae Hoon; Lee, Yu Min; Cho, Ji Hyun

doi:10.1007/s10156-011-0289-z

Cited by 53 publications

(35 citation statements)

References 13 publications

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“…12 In those situations, shock due to urosepsis is the most dangerous and, therefore, the risk factors need to be clear to achieve early diagnosis and treatment. 2 Risk factors may vary between institutions or hospitals due to different patient characteristics, so single-centre studies are somewhat limited.…”

Section: E107mentioning

confidence: 99%

Shock due to urosepsis: A multicentre study

Yamamichi

Shigemura

Kitagawa

et al. 2017

CUAJ

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Introduction: Urosepsis is a severe infection that can cause shock afterwards. The purpose of this study is to investigate the clinical and bacterial risk factors for shock in those cases with urosepsis caused by urinary tract infection in a multicentre study. Methods: Our study included 77 consecutive urosepsis cases from four hospitals. We examined factors such as patient characteristics, underlying disease, serum white blood cell (WBC) count, platelet count, C-reactive protein (CRP) level at the time of diagnosis of urosepsis, urinary tract occlusion, causative bacteria, and bacterial antibiotic susceptibilities. Statistical analyses were performed to assess the potential risk factors for shock during the clinical course of urosepsis by a multivariate analysis. Results: We had 38 male and 39 female patients aged 25-104 (median 73). Underlying diseases included cancers (n=22, 28.6 %) and diabetes mellitus (n=17, 22.1 %). Positive blood culture was seen in 74 cases; these involved 88 bacterial strains, of which Escherichia coli was the most common (34 strains, 38.6 %). There were 31 cases with shock (40.3 %) and multivariate analyses demonstrated that serum CRP was the only clinical risk factor for shock due to urosepsis. Conclusions: Our study demonstrated that serum CRP was a risk factor for shock during urosepsis in a multicentre analysis. Further prospective studies with a greater number of patients are needed to draw more definitive conclusions.

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Section: E107mentioning

confidence: 99%

Shock due to urosepsis: A multicentre study

Yamamichi

Shigemura

Kitagawa

et al. 2017

CUAJ

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“…14,15 In our study, which included more severe group of AP patients (ie those who required intensive care or urological interventions), the overall mortality rate was 7.4%. According to a previous study, 4 septic shock, bedridden status, age of >65 years, recent use of antibiotics, and immunosuppression were independent predictors of death.…”

Section: 12mentioning

confidence: 99%

Severe acute pyelonephritis: a review of clinical outcome and risk factors for mortality

et al. 2014

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Objective: To review demographics of patients with acute pyelonephritis, their outcomes of severe upper urinary tract infection, and to identify risk factors for long hospital stay and mortality.Design: Case series.Setting: A regional hospital in Hong Kong. Patients:Patients admitted between June 2007 and June 2012 for acute pyelonephritis were identified. Those with the most severe outcomes were analysed of their mortality, need for care in the intensive care unit, or necessitation of urological intervention. Results:Overall, 68 patients fulfilled our criteria for severe acute pyelonephritis. The female-to-male ratio was 7:3. Their mean age was 58 years. Overall, 57% of the patients had impaired renal function and 37% were diabetic; 47% developed shock after admission and 56% required further intensive care unit care; 75% of the patients demonstrated radiological evidence of urinary tract obstruction and required subsequent drainage procedures. Five patients died due to severe acute pyelonephritis. The prevalence of bacteraemia and bacteriuria was 57% and 74%, respectively. Escherichia coli accounted for the majority of causative organisms. Four risk factors-bacteraemia, shock, need for intensive care, and suppurative pyelonephritis-were associated

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“…Lee et al [9] also described that the patients with significant risk factors for septic shock were mostly admitted to the hospital from nursing homes.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, Lee et al [9] demonstrated that the overall mortality rate of bacteremic APN patients was 6.7% (14/208); however, the mortality rate of patients who presented with septic shock increased to 25.9%. Similarly, Koga et al [11] reported that septic shock occurred in 10 (20.8%) of 48 patients with calculous APN, but fortunately, no patient died from their disease.…”

Section: Discussionmentioning

confidence: 99%

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Risk Factors for Uroseptic Shock in Patients with Urolithiasis-Related Acute Pyelonephritis

et al. 2017

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Objectives: To analyze the risk factors of uroseptic shock induced by calculous acute pyelonephritis (APN). Methods: This study included 69 patients (41 were women and 28 were men) who were admitted to our hospital for APN treatment associated with urolithiasis during the period from January 2005 to December 2012. We reviewed the electronic medical records of these patients to analyze risk factors contributing to the development of uroseptic shock from APN in patients with urolithiasis. Results: Urinary drainage with ureteral stent or nephrostomy was carried out in 62 cases. Septic shock requiring vasopressor infusion against circulatory collapse was observed in 25 patients, these patients showed significantly lower serum albumin levels and higher C-reactive protein (CRP) compared to patients who did not exhibit septic shock. Multivariate analysis revealed that serum albumin level and CRP were the significant risk factors for the development of uroseptic shock from calculous APN. Conclusions: Serum albumin level was the significant risk factor for the development of uroseptic shock from calculous APN. Emergency drainage to decompress the obstructed urinary tract is mandatory as an initial urological intervention for the patients with lower serum albumin level.

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Risk factors of septic shock in bacteremic acute pyelonephritis patients admitted to an ER

Cited by 53 publications

References 13 publications

Shock due to urosepsis: A multicentre study

Shock due to urosepsis: A multicentre study

Severe acute pyelonephritis: a review of clinical outcome and risk factors for mortality

Risk Factors for Uroseptic Shock in Patients with Urolithiasis-Related Acute Pyelonephritis

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