Can excretory phase computed tomography predict bacteremia in obstructive calculous pyelonephritis?
| Autor: | Yoshitaka Arakaki, Shuichi Shimabukuro, Yusuke Yagihashi, Tomotune Toyosato |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Nephrology
Adult Male medicine.medical_specialty Urology 030232 urology & nephrology Bacteremia Urine Gastroenterology 03 medical and health sciences Kidney Calculi Young Adult 0302 clinical medicine Predictive Value of Tests Risk Factors Internal medicine medicine Humans Vasoconstrictor Agents Upper urinary tract Aged Aged 80 and over Univariate analysis Pyelonephritis business.industry Septic shock 030208 emergency & critical care medicine Odds ratio Middle Aged medicine.disease Acute Disease Female Complication business Tomography X-Ray Computed Ureteral Obstruction |
| Zdroj: | International urology and nephrology. 50(12) |
| ISSN: | 1573-2584 |
| Popis: | Acute pyelonephritis (AP), a complication of urolithiasis, can be fatal if it progresses to septic shock. We aimed to evaluate the performance of excretory phase computed tomography (CT) in predicting bacteremia among AP patients with upper urinary tract calculi. We reviewed medical records of 250 patients diagnosed with AP and upper urinary tract calculi and who were admitted to our institute. We analyzed 132 patients who underwent excretory phase CT. Excretory phase CT images were obtained 7 min after injection with the contrast agent. Obstruction was classified either as high or low grade. Univariate and multivariate analyses were performed to identify the risk factors of bacteremia. Of 132 patients, 73 (55.3%) had bacteremia. Escherichia coli was the most frequently identified pathogen in blood cultures. Univariate analysis demonstrated that high-grade obstruction on excretory phase CT and quick Sepsis-related Organ Failure Assessment (qSOFA) score ≥ 2 were correlated with bacteremia. In addition, the administration of vasopressors was significantly associated with bacteremia (31.5% vs. 6.8%; p |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink