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Predictors of septic shock in obstructive acute pyelonephritis
Mitsuhiro Tambo1, Takatsugu Okegawa, Toshihide Shishido
1Department of Urology, Kyorin University School of Medicine, 6-20-2, Shikawa, Mitaka, Tokyo, 181-8611, Japan, tanbodes@ks.kyorin-u.ac.jp.
World Journal of Urology
|September 17, 2013
Summary
Patients with obstructive acute pyelonephritis and upper urinary tract calculi face septic shock risks. Low platelet count and serum albumin are key indicators requiring cautious management.
Area of Science:
- Urology
- Nephrology
- Infectious Diseases
Background:
- Obstructive acute pyelonephritis (APN) with upper urinary tract calculi can lead to severe complications like sepsis and septic shock.
- Identifying risk factors for septic shock is crucial for timely intervention in these patients.
Purpose of the Study:
- To assess the risk factors for septic shock in patients diagnosed with obstructive APN associated with upper urinary tract calculi.
Main Methods:
- Retrospective study of 69 patients with obstructive APN and upper urinary tract calculi.
- Emergency drainage performed for severe cases or treatment failure.
- Multivariate logistic regression analysis used to identify risk factors for septic shock.
Main Results:
- 23.3% of patients developed septic shock.
- Septic shock group had higher rates of poor performance status and diabetes mellitus.
- Lower platelet counts and serum albumin levels were significantly observed in the septic shock group.
- Multivariate analysis identified decreased platelet count and serum albumin as independent risk factors for septic shock.
Conclusions:
- Patients with obstructive APN and upper urinary tract calculi presenting with decreased platelet count and serum albumin require vigilant monitoring for septic shock development.
- Early recognition of these risk factors can guide proactive management strategies to prevent severe outcomes.
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