901 CLINICAL COURSES OF ADULTS WITH ACUTE PYELONEPHRITIS CORRELATED WITH GRADE USING COMPUTED TOMOGRAPHY

Abstract

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Kidney & Bladder1 Apr 2012901 CLINICAL COURSES OF ADULTS WITH ACUTE PYELONEPHRITIS CORRELATED WITH GRADE USING COMPUTED TOMOGRAPHY Hyeong Gon Kim, Kyung Kyu Jun, Gwoan Youb Choo, Hyoung Keun Park, Sung Hyun Paick, and Yong Soo Lho Hyeong Gon KimHyeong Gon Kim Seoul, Korea, Republic of More articles by this author , Kyung Kyu JunKyung Kyu Jun Seoul, Korea, Republic of More articles by this author , Gwoan Youb ChooGwoan Youb Choo Seoul, Korea, Republic of More articles by this author , Hyoung Keun ParkHyoung Keun Park Seoul, Korea, Republic of More articles by this author , Sung Hyun PaickSung Hyun Paick Seoul, Korea, Republic of More articles by this author , and Yong Soo LhoYong Soo Lho Seoul, Korea, Republic of More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.997AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The aim of this study is to develop acute pyelonephritis (APN) grading system using computed tomography (CT) and find relationship with clinical courses of APN. METHODS We performed the prospective study between 2007 and 2011. All APN patients were underwent CT study and were divided into 4 grade groups according to the renal parenchyma involvement of infection on CT finding; grade 1: no lesion in CT, grade 2: <25% of parenchyma involvement, grade 3: 25% - 50% involvement and grade 4 group: >50% involvement. The severity index of APN was evaluated with the peak body temperature, the level of CRP and the level of leukocytosis. The recovery index was evaluated with the hospital days, duration of fever and duration of intravenous antibiotics treatment. The severity index and recovery index were compared among the patients groups. RESULTS A total of 234 patients were included in this study. Among these patients, urinary stone was found in 21 patients and renal abscess was found in 10 patients. Excluding these patients, analysis was performed in 204 patients. Mean peak temperature was 38.9°C. The level of c-reactive protein (CRP) elevation was 11.4 mg/dl and the level of white blood cell elevation was 12097.8 /ul. Mean hospital day was 6.5 days and the duration of fever was 1.6 days. As the increase of CT grading, the severity index including the peak body temperature, the level of CRP and the level of leukocytosis was significantly increased. In addition, the recovery index was increased according to the CT grading group. Hospital day was increased from 5.7 days in the group 1 to 7.6 days in the group 4 (p < 0.001) and fever duration was increased from 0.9 days in the group 1 to 1.9 days in the group 4 ( p = 0.005). CONCLUSIONS CT grading according to renal involvement was well correlated with the severity and recovery in APN patients. This CT grading might provides a useful tool to predict the clinical course of APN. Table 1. Comparisons according to APN grades Overall Group 1 Group 2 Group 3 Group 4 P value Severity index Peak body temperature (°) 38.9 38.2 38.6 39.1 38.9 0.001 Peak CRP (mg/dl) 11.4 3.6 6.8 12.4 21.9 0.000 Peak leukocytosis (/ul) 12098.1 9935.4 10210.6 12411.0 16005.4 0.000 Recovery index Hospital stay (days) 6.5 5.7 6.1 6.5 7.6 0.000 Fever duration (days) 1.5 0.9 1.4 1.7 1.9 0.005 Antibiotics duration (days) 6.2 5.5 5.9 6.1 7.4 0.000 © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e367 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hyeong Gon Kim Seoul, Korea, Republic of More articles by this author Kyung Kyu Jun Seoul, Korea, Republic of More articles by this author Gwoan Youb Choo Seoul, Korea, Republic of More articles by this author Hyoung Keun Park Seoul, Korea, Republic of More articles by this author Sung Hyun Paick Seoul, Korea, Republic of More articles by this author Yong Soo Lho Seoul, Korea, Republic of More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...