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Differences between Risk Factors for Sepsis and Septic Shock in Obstructive Urolithiasis
Sang Hyub Lee1, Taesoo Choi1, Jeonghyouk Choi1
1Department of Urology, School of Medicine, Kyung Hee University, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
Journal of Korean Medical Science
|November 10, 2020
Summary
Complicated acute pyelonephritis (APN) from ureteral stones presents risks for sepsis and septic shock. Identifying risk factors like prior stones and specific lab values aids in managing this severe condition.
Area of Science:
- Nephrology
- Urology
- Infectious Disease
Background:
- Complicated acute pyelonephritis (APN) is a severe condition requiring prompt treatment.
- Ureteral stones are a significant cause of complicated APN.
Purpose of the Study:
- To investigate the clinical characteristics of APN associated with ureteral stones.
- To identify risk factors for sepsis and septic shock in APN patients with ureteral stones.
Main Methods:
- Retrospective review of 85 patients with APN and ureteral stones.
- Exclusion of patients with complicating factors like renal stones or ureteral strictures.
- Analysis of clinical data and laboratory results to determine risk factors for sepsis and septic shock.
Main Results:
- Sepsis occurred in 62 patients, with 17 progressing to septic shock.
- Previous stone history, leukocytosis, elevated C-reactive protein, and low albumin were risk factors for sepsis.
- Absence of hypertension, thrombocytopenia, decreased ESR, and elevated BUN predicted septic shock.
Conclusions:
- Risk factors for progression to sepsis differ from those for progression to septic shock.
- Aggressive management and close monitoring are crucial for APN with ureteral stones, especially with identified risk factors.
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