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Serious acute pyelonephritis: a predictive score for evaluation of deterioration of treatment based on clinical and radiologic findings using CT

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Author(s)
See Hyung KimYoung Whan KimHee Jung Lee
Keimyung Author(s)
Kim, See HyungKim, Young HwanLee, Hee Jung
Department
Dept. of Radiology (영상의학)
Journal Title
Acta Radiologica
Issued Date
2012
Volume
53
Issue
2
Abstract
Background: Acute pyelonephritis (APN) requires prompt diagnosis and immediate treatment.
Purpose: To develop a simple score to assist in diagnosing treatment deterioration in patients with serious
APN.
Material and Methods: Using data from a retrospective cohort of 193 patients with APN, we developed
scores based on multivariate logistic regression after the jackknife procedure. We validated the scores in a
prospective cohort of 40 patients.
Results: Nine criteria were independently associated with our investigation: Abscess (adjusted odds ratio
[OR], 19.8; 95% confidence interval [95% CI] 4.5–72.1), pyonephrosis with or without stone (18.3; 4.8–70.9),
pelvicalyceal air (15.5; 3.2–26.9), poor global excretion of contrast (12.3; 2.9–68.5), tachycardia or hypotension
(10.1; 2.5–28.0), obliteration of the renal sinus (9.6; 2.5–45.2), persistent fever or pyuria (9.8; 1.9–25.8),
diabetes (9.4; 2.0–31.8), and global renal enlargement (7.5; 2.1–35.8). The APN scorewas based on these nine
criteria. Low-risk and high-risk groups were derived from the score (probability, 3.5% [95% CI 0–7.5] and
67% [51–83]). Application of these criteria to the prospective cohort confirmed the diagnostic accuracy of
the score (probability 0% [0–15] and 71% [25–100] in the low-risk and high-risk groups, respectively).
Conclusion: This easy-to-calculate score may prove useful for diagnosing patients with serious APN who
deteriorate with treatment.
Keywords: Acute pyelonephritis (APN), CT, jackknife procedure
Keimyung Author(s)(Kor)
김시형
김영환
이희정
Publisher
School of Medicine
Citation
See Hyung Kim et al. (2012). Serious acute pyelonephritis: a predictive score for evaluation of deterioration of treatment based on clinical and radiologic findings using CT. Acta Radiologica, 53(2), 233–238. doi: 10.1258/ar.2011.110507
Type
Article
ISSN
0284-1851
Source
http://journals.sagepub.com.proxy.dsmc.or.kr/doi/abs/10.1258/ar.2011.110507?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed
DOI
10.1258/ar.2011.110507
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/34862
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Radiology (영상의학)
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