PD21-05 EVALUATION OF EARLY SCORING PREDICTORS FOR EXPEDITED CARE IN A LARGE PROSPECTIVE PATIENTS’ COHORT WITH EMPHYSEMATOUS PYELONEPHRITIS

Abstract

You have accessJournal of UrologyCME1 May 2022PD21-05 EVALUATION OF EARLY SCORING PREDICTORS FOR EXPEDITED CARE IN A LARGE PROSPECTIVE PATIENTS’ COHORT WITH EMPHYSEMATOUS PYELONEPHRITIS Arun Chawla, Sunil Pillai, Ravi Taori, and Arun Chawla Arun ChawlaArun Chawla More articles by this author , Sunil PillaiSunil Pillai More articles by this author , Ravi TaoriRavi Taori More articles by this author , and Arun ChawlaArun Chawla More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002559.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To evaluate and position existing critical care scoring systems to predict the need for ICU (Intensive Care Unit) management for patients with Emphysematous Pyelonephritis (EPN). To also analyze if CT-imaging further enhances the predictive systems. METHODS: Analysis of prospectively maintained database of consecutive patients diagnosed clinico-radiologically with EPN from January 2011 to September 2020. Five scoring systems were evaluated for their predictive ability for the need for ICU management and mortality risk: National Early Warning Score (NEWS), Modified Early Warning Score (MEWS), ‘quick’ Sequential Organ Failure Assessment score (qSOFA), Systemic Inflammatory Response Syndrome score (SIRS), and Sequential Organ Failure Assessment score (SOFA). CT images were graded and evaluated as stand-alone or added to the different predictive models. Receiver operating characteristic (ROC) curves were plotted for each critical care score and CT-grade using logistic regression, to obtain the area under curve (AUC) value for comparison of ICU admission predictability. RESULTS: 90 patients were diagnosed with EPN. Twenty-six patients required ICU management and nine patients died. The best scoring system to predict the need of early ICU management is NEWS (AUC 0.884). CT imaging does further improve, though not statistically significant, the predictive model of NEWS from 0.884 to 0.894. Supplement Table 2: Comparison of ROC curves of the various scores. CONCLUSIONS: In patients with EPN, the NEWS scoring system predicts best the requirement of ICU care. It aids in triage of patients with EPN to appropriate early management and reduce mortality risk. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e362 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Arun Chawla More articles by this author Sunil Pillai More articles by this author Ravi Taori More articles by this author Arun Chawla More articles by this author Expand All Advertisement PDF DownloadLoading ...