Michinobu Ozawa1,2, Osamu Ichiyanagi3, Suguru Fujita3,4, Sei Naito3, Hiroki Fukuhara3,4, Shinta Suenaga5, Satoshi Takai1, Takafumi Narisawa1,3, Noriyuki Hosoya6, Tatsuya Ishii7,8, Takuya Yamanobe3,6, Akinori Muto9, Hitoshi Suzuki8, Hayato Nishida3, Tomoyuki Kato3, Norihiko Tsuchiya3. 1. Department of Urology, Okitama Public General Hospital, Kawanishi, Japan. 2. Department of Urology, Yamagata Prefectural Central Hospital, Yamagata, Japan. 3. Department of Urology, Yamagata University Faculty of Medicine, Yamagata, Japan. 4. Department of Urology, Nihonkai General Hospital, Yamagata, Japan. 5. Department of Urology, Tsuruoka Municipal Shonai Hospital, Tsuruoka, Japan. 6. Department of Urology, Yamagata Prefectural Kahoku Hospital, Yamagata, Japan. 7. Department of Urology, South Miyagi Medical Center, Miyagi, Japan. 8. Department of Urology, Yamagata City Hospital Saiseikan, Yamagata, Japan. 9. Department of Urology, Yamagata Prefectural Shinjo Hospital, Shinjo, Japan.
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.
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.
Authors: Daniel Olvera-Posada; Ghislaine Armengod-Fischer; Luis G Vázquez-Lavista; Miguel Maldonado-Ávila; Emmanuel Rosas-Nava; Hugo Manzanilla-García; Ricardo A Castillejos-Molina; Carlos E Méndez-Probst; Mariano Sotomayor; Guillermo Feria-Bernal; Francisco Rodríguez-Covarrubias Journal: Urology Date: 2014-04-13 Impact factor: 2.649
Authors: Xuan Thai Ngo; Tuan Thanh Nguyen; Ryan W Dobbs; Minh Sam Thai; Duc Huy Vu; Le Quy Van Dinh; Khoa Quy; Hieu Trong Le; Tien-Dat Hoang; Hanh Thi Tuyet Ngo; Trinh Ngoc Khanh Van; Ho Yee Tiong; Huy Gia Vuong Journal: World J Surg Date: 2022-07-08 Impact factor: 3.282