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자료유형
학술저널
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저널정보
대한중환자의학회 Acute and Critical Care Acute and Critical Care 제27권 제2호
발행연도
2012.1
수록면
89 - 93 (5page)

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Background: Emphysematous pyelonephritis (EPN) is a rare and potentially life-threatening condition that requires prompt evaluation and management. However, its clinical presentation and outcomes vary widely. This study was conducted to ascertain the clinical features and prognostic factors regarding EPN. Methods: All patients diagnosed with EPN radiologically and treated at the emergency department in the university- affiliated, tertiary-referral center, from January 1999 to December 2009 were evaluated. The patients’ demographic and clinical characteristics, computed tomographic findings, treatment, and outcomes were analyzed retrospectively. Results: Overall 14 patients diagnosed with EPN were admitted. There were 12 females and 2 males. A history of diabetes was found in 12 (85.7%) patients and was the most common comorbidity. The chief complaint among patients was flank pain (42.9%). Severe sepsis or septic shock was noted in 10 (71.4%) patients. Thirteen cases had unilateral involvement and one case had bilateral involvement. More than half of patients had Escherichia.coli in culture. Mean serum levels of HbA1c, creatinine, C-reactive protein (CRP) were 9.4 ± 2.7, 2.4 ± 1.4 mg/dl, and 22.4 ± 13.1 mg/dl. Eight (57.1%) patients received antibiotic treatment alone and four (28.6%) patients received the concurrent percutaneous drainage as well as antibiotics. Hospital mortality was 7.1%. A higher initial serum CRP level (20.3 vs. 49.8 mg/dl, p = 0.02) and HbA1c level (8.7 vs. 16.4, p = 0.01) was associated with hospital mortality. Conclusions: Antibiotics alone provide a high success rate for the treatment of EPN. Higher serum CRP and HbA1c level was associated with a higher mortality rate in patients with EPN.
#computed tomography #diabetes mellitus #emphysematous pyelonephritis #outcome.

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참고문헌 (18)

참고문헌 신청
Ahlering TE / 1985 / Emphysematous pyelonephritis: a 5-year experience with 13 patients / J Urol 134 : 1086 ~ 1088 google schola Baliga KV / 2007 / Successful medical treatment of emphysematous pyelonephritis in a renal allograft recipient / Ren Fail 29 : 755 ~ 758 google schola Huang JJ / 2000 / Emphysematous pyelonephritis: clinicoradiological classification, management, prognosis, and pathogenesis / Arch Intern Med 160 : 797 ~ 805 google schola Kapoor R / 2010 / Predictive factors for mortality and need for nephrectomy in patients with emphysematous pyelonephritis / BJU Int 105 : 986 ~ 989 google schola Khaira A / 2009 / Retrospective analysis of clinical profile prognostic factors and outcomes of 19 patients of emphysematous pyelonephritis / Int Urol Nephrol 41 : 959 ~ 966 google schola

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