Diabetes Mellitus Does Not Predict Discharge in Hospitalized Patients With Acute Pyelonephritis: A Study From...

Area of Science:

• Nephrology
• Endocrinology
• Infectious Diseases

Background:

• Acute pyelonephritis (APN) presents with higher incidence and complexity in diabetic patients.
• Complicated pyelonephritis (PN) typically requires hospitalization and intravenous antibiotics.
• The impact of comorbidities, including diabetes, on hospital stay duration for PN is not fully elucidated.

Purpose of the Study:

• To investigate the independent effect of diabetes mellitus on the length of hospital stay (LOS) for patients admitted with acute pyelonephritis.
• To identify factors associated with prolonged hospital stay (≥ five days) in acute pyelonephritis patients.

Main Methods:

• Retrospective analysis of 520 hospitalized acute pyelonephritis patients from March 2015 to December 2019.
• Utilized electronic medical records and ICD-10 coding for condition identification.
• Employed Chi-squared tests and logistic regression for statistical analysis of LOS (< five days vs. ≥ five days).

Main Results:

• Diabetes mellitus was present in 51.2% of patients; 53% of these had LOS ≥ five days.
• Factors positively associated with LOS ≥ five days included older age, upper/lower urinary tract symptoms, and elevated creatinine (> 1.5 mg/dl).
• Diabetes mellitus was not independently associated with LOS ≥ five days (OR: 0.9, 95%CI: 0.8 - 1.5).

Conclusions:

• Diabetes mellitus is not an independent predictor of prolonged hospital stay (≥ five days) in patients with acute pyelonephritis.
• Clinical factors such as age, symptom presentation, and renal function are more significantly associated with extended hospitalization for APN.
• Findings suggest that management strategies for APN in diabetic patients may not need to specifically target prolonged LOS based solely on diabetes status.