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Author Spotlight: Developing a Bedside Protocol for Kidney and Genitourinary Ultrasonography
Published on: June 21, 2024
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Emergency Department Urosepsis and Abdominal Imaging
Mansoor Siddiqui1, Dena Abuelroos2, Lihua Qu3
1Emergency Medicine, Henry Ford Health System, Detroit, MI, USA.
Cureus
|June 4, 2021
Summary
Nearly half of emergency department patients with urosepsis required emergent surgical consultation based on abdominal imaging findings. Further prospective studies are needed to confirm the utility of imaging in urosepsis management.
Area of Science:
- Emergency Medicine
- Urology
- Radiology
Background:
- Urosepsis management lacks established imaging protocols.
- Current clinical decision rules for imaging in urosepsis are absent.
- There is a need to evaluate the diagnostic yield of imaging in urosepsis.
Purpose of the Study:
- To retrospectively assess emergency department patients with urosepsis who underwent abdominal imaging.
- To determine the proportion of uroseptic patients with imaging findings necessitating emergent surgical consultation.
- To analyze the impact of urinalysis results on the need for surgical consultation.
Main Methods:
- Retrospective review of 1142 adult patients with urosepsis from January 2009 to December 2012.
- Inclusion criteria: ICD9 code for urosepsis, ED-ordered abdominal CT or retroperitoneal US.
- Exclusion criteria: Negative urinalysis, <2 SIRS criteria, positive blood cultures, incomplete data.
Main Results:
- 538 patients were included in the final analysis.
- 45% of patients had imaging findings requiring emergent surgical consultation.
- 33% of these patients underwent a surgical or interventional procedure.
- Similar consultation rates were observed for positive (43%) and equivocal (47%) urinalysis results.
Conclusions:
- Abdominal imaging in urosepsis frequently identifies findings that necessitate emergent surgical consultation.
- The utility of abdominal imaging in urosepsis warrants further prospective investigation.
- Imaging plays a critical role in guiding surgical intervention decisions for urosepsis patients.
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