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Risk of SOFA Deterioration in Conservative Treatment for Emphysematous Pyelonephritis: Pitfalls of Current Trends in Therapeutics from Multicenter Clinical Experience.
Ozawa, Michinobu; Ichiyanagi, Osamu; Fujita, Suguru; Naito, Sei; Fukuhara, Hiroki; Suenaga, Shinta; Takai, Satoshi; Narisawa, Takafumi; Hosoya, Noriyuki; Ishii, Tatsuya; Yamanobe, Takuya; Muto, Akinori; Suzuki, Hitoshi; Nishida, Hayato; Kato, Tomoyuki; Tsuchiya, Norihiko.
Afiliación
  • Ozawa M; Department of Urology, Okitama Public General Hospital, Kawanishi, Japan.
  • Ichiyanagi O; Department of Urology, Yamagata Prefectural Central Hospital, Yamagata, Japan.
  • Fujita S; Department of Urology, Yamagata University Faculty of Medicine, Yamagata, Japan.
  • Naito S; Department of Urology, Yamagata University Faculty of Medicine, Yamagata, Japan.
  • Fukuhara H; Department of Urology, Nihonkai General Hospital, Yamagata, Japan.
  • Suenaga S; Department of Urology, Yamagata University Faculty of Medicine, Yamagata, Japan.
  • Takai S; Department of Urology, Yamagata University Faculty of Medicine, Yamagata, Japan.
  • Narisawa T; Department of Urology, Nihonkai General Hospital, Yamagata, Japan.
  • Hosoya N; Department of Urology, Tsuruoka Municipal Shonai Hospital, Tsuruoka, Japan.
  • Ishii T; Department of Urology, Okitama Public General Hospital, Kawanishi, Japan.
  • Yamanobe T; Department of Urology, Okitama Public General Hospital, Kawanishi, Japan.
  • Muto A; Department of Urology, Yamagata University Faculty of Medicine, Yamagata, Japan.
  • Suzuki H; Department of Urology, Yamagata Prefectural Kahoku Hospital, Yamagata, Japan.
  • Nishida H; Department of Urology, South Miyagi Medical Center, Miyagi, Japan.
  • Kato T; Department of Urology, Yamagata City Hospital Saiseikan, Yamagata, Japan.
  • Tsuchiya N; Department of Urology, Yamagata University Faculty of Medicine, Yamagata, Japan.
Curr Urol ; 12(3): 134-141, 2019 May 10.
Article en En | MEDLINE | ID: mdl-31316321
ABSTRACT

INTRODUCTION:

We investigated relationships between therapeutic outcomes of patients with emphysematous pyelonephritis (EPN) and changes in the Sequential Organ Failure Assessment (SOFA) score. MATERIALS AND

METHODS:

We retrospectively evaluated EPN patients treated in our hospitals using the SOFA score incorporated in the Sepsis-3 updated in 2016.

RESULTS:

Seventeen typical EPN patients were included in this study, and were treated with medical management with no drainage (n = 3), retrograde stenting (n = 10), or percutaneous drainage (n = 3). One patient without drainage died of sepsis, yielding an overall mortality rate of 5.9%. Twelve patients recovered without increase in the SOFA score during hospitalization. However, the SOFA score deteriorated in the other patients from admission, with the initial scores not significantly different from those of the 12 cases. The changes in the SOFA score were significantly affected by the selected approaches of drainage (100% patients for no drainage, 22% for stenting, and 0% for percutaneous drainage, p = 0.029), but not by other clinical data.

CONCLUSION:

Most EPN patients can currently be conservatively managed successfully. However, it should be noted that less-invasive management could cause deterioration in SOFA after admission, yielding a risk of septic mortality.
Palabras clave

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Etiology_studies / Risk_factors_studies Idioma: En Revista: Curr Urol Año: 2019 Tipo del documento: Article País de afiliación: Japón

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Etiology_studies / Risk_factors_studies Idioma: En Revista: Curr Urol Año: 2019 Tipo del documento: Article País de afiliación: Japón
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