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요로 결석 환자에서 급성 신우신염의 예측인자로 hs-C-reactive protein의 유용성

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Affiliated Author(s)
진상찬김성진최우익
Alternative Author(s)
Jin, Sang ChanKim, Sung JinChoi, Woo Ik
Journal Title
대한응급의학회지
ISSN
1226-4334
Issued Date
2014
Abstract
Purpose: The aim of this study was to determine early predictive value of acute pyelonephritis and urosepsis in patients with urolithiasis in the emergency department.
Methods: We retrospectively reviewed medical records of patients who visited the emergency department and were diagnosed with urolithiasis by computed tomography for three years. Patients with urolithiasis were grouped according to the presence of computed tomography (CT) findings with acute pyelonephritis. In baseline characteristics, laboratory and CT findings of the two groups were compared. Group 1 was defined as urolithiasis without acute pyelonephritis and group 2 was defined as urolithiasis with acute pyelonephritis. In addition, we compared the sepsis versus non-sepsis and percutaneous nephrostomy (PCN) versus non-PCN group in Group 2 for analysis of the hs- CRP level of each group.
Results: The total number of urolithiasis patients was 744. Among the patients, 84 (11.3%) had urolithiasis with acute pyelonephritis in CT findings. Age, sex, history of diabetes, history of urolithiasis, size of stone, duration of symptom, body temperature, blood pressure, heart rate, respiratory rate, leukocyte count, existence of pyuria, and hs-CRP differed significantly between the two groups, respectively. In multivariate logistic regression analysis, age, history of urolithiasis, existence of pyuria, and hs-CRP were shown to be independent predictors affecting acute pyelonephritis in patients with urolithiasis. The area under the receiving operator characteristics (ROC) curve for CRP was 0.820 (95% CI, 0.754-0.886) and leukocyte count was 0.631 [95% confidence interval (CI), 0.542-0.721]. Sepsis and PCN groups showed significantly higher hs-CRP level than non-sepsis and non-PCN groups.
Conclusion: There were some independent predictive values of urolithiasis with acute pyelonephritis. It can be useful in early detection of acute pyelonephritis or sepsis, and it can be helpful in making treatment plans for patients of urolithiasis.
Alternative Title
Availability of hs-C-reactive protein as Predictive Value of Acute Pyelonephritis with Patient of Urolithiasis
Department
Dept. of Emergency Medicine (응급의학)
Publisher
School of Medicine
Citation
박진욱 et al. (2014). 요로 결석 환자에서 급성 신우신염의 예측인자로 hs-C-reactive protein의 유용성. 대한응급의학회지, 25(4), 463–470.
Type
Article
ISSN
1226-4334
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/38262
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학)
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