Reappraisal of the Management and Outcome of Emphysematous Pyelonephritis
| Autor: | Hsein-Jar Chiang, Jeon-Hor Chen, Wu-Chung Shen, Chao-Hsiang Chang, Yung-Fang Chen, Chien-Heng Lin, Yi-Chang Cheng, Yung-Jen Ho, Yuan-Hong Tzeng, Wei-Ching Lin |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty Percutaneous medicine.medical_treatment emphysematous pyelonephritis Emphysematous pyelonephritis Post-hoc analysis medicine nephrectomy Humans Dialysis Aged Medicine(all) Aged 80 and over Emphysema lcsh:R5-920 Medical treatment Pyelonephritis business.industry Incidence (epidemiology) General Medicine Middle Aged percutaneous catheter drainage medicine.disease Nephrectomy Surgery Radiography Treatment Outcome Heart failure Drainage Female business lcsh:Medicine (General) |
| Zdroj: | Kaohsiung Journal of Medical Sciences, Vol 25, Iss 1, Pp 16-24 (2009) |
| Popis: | This study compared the management, prognostic factors and outcomes of patients with emphysematous pyelonephritis (EPN). Twenty-one patients with EPN were studied between September 1996 and August 2005, and were assigned to two groups. Patients in Group 1 received conservative treatment with/without percutaneous catheter drainage (PCD) while patients in Group 2 underwent nephrectomy following medical treatment and PCD. A post hoc analysis of the prognostic factors was performed between survivors and nonsurvivors, and between the survivors in Group 1 and Group 2. There were 14 patients in Group 1, and seven in Group 2. The mortality in Group 1 was 35.7% (5/14) and in Group 2 was 0% (p = 0.12). There were no statistically significant differences in prognostic factors between the two groups, though patients in Group 1 had relatively lower platelet counts (p = 0.07) and Group 2 patients had a higher incidence of dialysis after nephrectomy (p = 0.03). Comparing the survivors and nonsurvivors, patients with comorbid congestive heart failure and patients initially presenting with consciousness disturbances had higher mortalities (p = 0.02 and p < 0.01, respectively). Nonsurvivors also had lower platelet counts (p = 0.06). In conclusion, medical treatment with/without PCD can be used to manage patients with EPN. More aggressive drainage is needed in patients with congestive heart failure who initially present with consciousness disturbances or thrombocytopenia. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|