Predictors of ultrasound abnormalities among women treated for community-onset acute pyelonephritis: a prospective study
Objectives Acute pyelonephritis (AP) is a common but potentially severe infection. It may be complicated by pyelocaliceal dilatation which requires emergency urine drainage. In outpatient care, ultrasound (US) appears to be the easier way to diagnose pyelocaliceal dilatation, though most APs will no...
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Published in: | World journal of urology 2022-10, Vol.40 (10), p.2499-2504 |
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Main Authors: | , , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
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Summary: | Objectives
Acute pyelonephritis (AP) is a common but potentially severe infection. It may be complicated by pyelocaliceal dilatation which requires emergency urine drainage. In outpatient care, ultrasound (US) appears to be the easier way to diagnose pyelocaliceal dilatation, though most APs will not be complicated and do not require immediate ultrasound. We aimed to identify predictors of ultrasound abnormalities in an outpatient AP cohort.
Methods
A prospective study was conducted from April 2006 to September 2019 in an outpatient care network. Patients aged 15 and over treated for AP were included. Men, pregnant women, patients with solitary kidney, and patients without data on their management were excluded. A common algorithm ensured the same approach from diagnosis to treatment. Data were collected prospectively in an anonymized database. We described the characteristics of the patients. Univariate and then multivariate analyses were performed to identify predictors of ultrasound abnormalities.
Results
2054 women were treated for AP. Among them, 32.5% (
n
= 667) had a history of urinary tract infections and 5.8% (
n
= 120) of uropathy. The most frequent uropathogen was
E. coli
(
n
= 1,432; 69.7%); Extended-Spectrum Beta-Lactamases (ESBLs) were found in 39 (1.9%) urine cultures. Ultrasound was abnormal in 7.3% (
n
= 149). Age over 55 years (OR = 2.23; 95% CI 1.58‒3.15; p |
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ISSN: | 1433-8726 0724-4983 1433-8726 |
DOI: | 10.1007/s00345-022-04112-1 |