Clinical Profile and Predictors of Outcomes in Older Inpatients with Pyelonephritis in a Tertiary Care Hospital in Southern India

• Published in: Journal of clinical and diagnostic research 2015-10, Vol.9 (10), p.OC05-OC07
• Main Authors: Gopal, Gopinath Kango, Wilson, Benny Paul, Viggeswarpu, Surekha, Sathyendra, Sowmya, Iyyadurai, Ramya, Visvanathan, Renuka, Mathews, Kuruvilla Prasad
• Format: Article
• Language: English
• Subjects: albumin; delirium; esbl; geriatric; india; Internal Medicine Section; mortality; pyelonephritis
• ISSN: 2249-782X; 0973-709X
• DOI: 10.7860/JCDR/2015/15964.6616

Pyelonephritis is a serious infection associated with significant morbidity and mortality in the elderly with an estimated annual incidence rate of around 10% from previous studies. Older people are at a higher risk for pyelonephritis due to multiple factors including structural, functional and co-existent conditions. There is very little data on the incidence, clinical features and outcomes among elderly patients with pyelonephritis in India. We performed a retrospective review of case records of 100 consecutive patients over the age of 60 years with pyelonephritis admitted to a tertiary care hospital. One fourth of our patients (26%) did not have fever, 49% had delirium and 52% had systemic inflammatory response syndrome (SIRS). Sixty five percent of the patients were diabetic and 60% had infections caused by extended spectrum beta lactamase (ESBL) producing organisms. As in other studies, the commonest organism isolated was E.coli (49%). A low serum albumin level was a predictor of mortality (p