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Can excretory phase computed tomography predict bacteremia in obstructive calculous pyelonephritis?
Purpose Acute pyelonephritis (AP), a complication of urolithiasis, can be fatal if it progresses to septic shock. We aimed to evaluate the performance of excretory phase computed tomography (CT) in predicting bacteremia among AP patients with upper urinary tract calculi. Methods We reviewed medical...
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| Published in: | International urology and nephrology 2018-12, Vol.50 (12), p.2123-2129 |
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| creator | Yagihashi, Yusuke Shimabukuro, Shuichi Toyosato, Tomotune Arakaki, Yoshitaka |
| description | Purpose
Acute pyelonephritis (AP), a complication of urolithiasis, can be fatal if it progresses to septic shock. We aimed to evaluate the performance of excretory phase computed tomography (CT) in predicting bacteremia among AP patients with upper urinary tract calculi.
Methods
We reviewed medical records of 250 patients diagnosed with AP and upper urinary tract calculi and who were admitted to our institute. We analyzed 132 patients who underwent excretory phase CT. Excretory phase CT images were obtained 7 min after injection with the contrast agent. Obstruction was classified either as high or low grade. Univariate and multivariate analyses were performed to identify the risk factors of bacteremia.
Results
Of 132 patients, 73 (55.3%) had bacteremia.
Escherichia coli
was the most frequently identified pathogen in blood cultures. Univariate analysis demonstrated that high-grade obstruction on excretory phase CT and quick Sepsis-related Organ Failure Assessment (qSOFA) score ≥ 2 were correlated with bacteremia. In addition, the administration of vasopressors was significantly associated with bacteremia (31.5% vs. 6.8%;
p
|
| doi_str_mv | 10.1007/s11255-018-1999-2 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2119926440</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2119926440</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-1da97d1ca9979724707a19382d7c9b7c2f036a338c353571999fe8e005c5bb7a3</originalsourceid><addsrcrecordid>eNp1kUtLxDAUhYMoOj5-gBspuHFTvUmaplmJDL5AcKPrkKZ3nErb1CQV59-bYXyA4Oou7nfOPckh5JjCOQWQF4FSJkQOtMqpUipnW2RGheQ5E1WxTWbAgea0ZHyP7IfwCgCqAtglexw4FUVVzoidmyHDD-sxOr_KxqUJmFnXj1PEJouudy_ejMu08di0Nma1sRE99q3J2iFzdYh-srF9TyrT2alzU8jGFXZuwHHp29iGy0OyszBdwKOveUCeb66f5nf5w-Pt_fzqIbdcspjTxijZUGuUkkqyQoI0VPGKNdKqWlq2AF4azivLBRdy_eIFVgggrKhrafgBOdv4jt69TRii7ttgsevMgCmWZjRpWFkUkNDTP-irm_yQ0q2pqmQycYmiG8p6F4LHhR592xu_0hT0ugG9aUCnBvQ6j2ZJc_LlPNU9Nj-K7y9PANsAIa2GF_S_p_93_QR54ZGI</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2118627264</pqid></control><display><type>article</type><title>Can excretory phase computed tomography predict bacteremia in obstructive calculous pyelonephritis?</title><source>Springer Nature</source><creator>Yagihashi, Yusuke ; Shimabukuro, Shuichi ; Toyosato, Tomotune ; Arakaki, Yoshitaka</creator><creatorcontrib>Yagihashi, Yusuke ; Shimabukuro, Shuichi ; Toyosato, Tomotune ; Arakaki, Yoshitaka</creatorcontrib><description>Purpose
Acute pyelonephritis (AP), a complication of urolithiasis, can be fatal if it progresses to septic shock. We aimed to evaluate the performance of excretory phase computed tomography (CT) in predicting bacteremia among AP patients with upper urinary tract calculi.
Methods
We reviewed medical records of 250 patients diagnosed with AP and upper urinary tract calculi and who were admitted to our institute. We analyzed 132 patients who underwent excretory phase CT. Excretory phase CT images were obtained 7 min after injection with the contrast agent. Obstruction was classified either as high or low grade. Univariate and multivariate analyses were performed to identify the risk factors of bacteremia.
Results
Of 132 patients, 73 (55.3%) had bacteremia.
Escherichia coli
was the most frequently identified pathogen in blood cultures. Univariate analysis demonstrated that high-grade obstruction on excretory phase CT and quick Sepsis-related Organ Failure Assessment (qSOFA) score ≥ 2 were correlated with bacteremia. In addition, the administration of vasopressors was significantly associated with bacteremia (31.5% vs. 6.8%;
p
< 0.001). Multivariate analysis identified high-grade obstruction on excretory phase CT [odds ratio (OR) 6.68;
p
< 0.001] and qSOFA score ≥ 2 (OR 3.59,
p
= 0.03) as independent risk factors for bacteremia.
Conclusions
Excretory phase CT images can be used to predict bacteremia by evaluating the degree of ureteral obstruction. The evaluation of the passage of urine shown by excretory phase CT is critical in patients with AP associated with upper urinary tract calculi.</description><identifier>ISSN: 0301-1623</identifier><identifier>EISSN: 1573-2584</identifier><identifier>DOI: 10.1007/s11255-018-1999-2</identifier><identifier>PMID: 30315486</identifier><language>eng</language><publisher>Dordrecht: Springer Netherlands</publisher><subject>Acute Disease ; Adult ; Aged ; Aged, 80 and over ; Bacteremia ; Bacteremia - etiology ; Bacteremia - microbiology ; Computed tomography ; Female ; Humans ; Kidney Calculi - complications ; Kidney Calculi - diagnostic imaging ; Lithiasis ; Male ; Medical records ; Medicine ; Medicine & Public Health ; Middle Aged ; Multivariate analysis ; Nephrology ; Predictive Value of Tests ; Pyelonephritis ; Pyelonephritis - diagnostic imaging ; Pyelonephritis - etiology ; Risk Factors ; Sepsis ; Septic shock ; Tomography ; Tomography, X-Ray Computed - methods ; Ureteral Obstruction - complications ; Ureteral Obstruction - diagnostic imaging ; Urinary tract ; Urine ; Urogenital system ; Urology ; Urology - Original Paper ; Vasoconstrictor Agents - therapeutic use ; Young Adult</subject><ispartof>International urology and nephrology, 2018-12, Vol.50 (12), p.2123-2129</ispartof><rights>Springer Nature B.V. 2018</rights><rights>International Urology and Nephrology is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-1da97d1ca9979724707a19382d7c9b7c2f036a338c353571999fe8e005c5bb7a3</citedby><cites>FETCH-LOGICAL-c372t-1da97d1ca9979724707a19382d7c9b7c2f036a338c353571999fe8e005c5bb7a3</cites><orcidid>0000-0002-7827-7339</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30315486$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yagihashi, Yusuke</creatorcontrib><creatorcontrib>Shimabukuro, Shuichi</creatorcontrib><creatorcontrib>Toyosato, Tomotune</creatorcontrib><creatorcontrib>Arakaki, Yoshitaka</creatorcontrib><title>Can excretory phase computed tomography predict bacteremia in obstructive calculous pyelonephritis?</title><title>International urology and nephrology</title><addtitle>Int Urol Nephrol</addtitle><addtitle>Int Urol Nephrol</addtitle><description>Purpose
Acute pyelonephritis (AP), a complication of urolithiasis, can be fatal if it progresses to septic shock. We aimed to evaluate the performance of excretory phase computed tomography (CT) in predicting bacteremia among AP patients with upper urinary tract calculi.
Methods
We reviewed medical records of 250 patients diagnosed with AP and upper urinary tract calculi and who were admitted to our institute. We analyzed 132 patients who underwent excretory phase CT. Excretory phase CT images were obtained 7 min after injection with the contrast agent. Obstruction was classified either as high or low grade. Univariate and multivariate analyses were performed to identify the risk factors of bacteremia.
Results
Of 132 patients, 73 (55.3%) had bacteremia.
Escherichia coli
was the most frequently identified pathogen in blood cultures. Univariate analysis demonstrated that high-grade obstruction on excretory phase CT and quick Sepsis-related Organ Failure Assessment (qSOFA) score ≥ 2 were correlated with bacteremia. In addition, the administration of vasopressors was significantly associated with bacteremia (31.5% vs. 6.8%;
p
< 0.001). Multivariate analysis identified high-grade obstruction on excretory phase CT [odds ratio (OR) 6.68;
p
< 0.001] and qSOFA score ≥ 2 (OR 3.59,
p
= 0.03) as independent risk factors for bacteremia.
Conclusions
Excretory phase CT images can be used to predict bacteremia by evaluating the degree of ureteral obstruction. The evaluation of the passage of urine shown by excretory phase CT is critical in patients with AP associated with upper urinary tract calculi.</description><subject>Acute Disease</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Bacteremia</subject><subject>Bacteremia - etiology</subject><subject>Bacteremia - microbiology</subject><subject>Computed tomography</subject><subject>Female</subject><subject>Humans</subject><subject>Kidney Calculi - complications</subject><subject>Kidney Calculi - diagnostic imaging</subject><subject>Lithiasis</subject><subject>Male</subject><subject>Medical records</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>Nephrology</subject><subject>Predictive Value of Tests</subject><subject>Pyelonephritis</subject><subject>Pyelonephritis - diagnostic imaging</subject><subject>Pyelonephritis - etiology</subject><subject>Risk Factors</subject><subject>Sepsis</subject><subject>Septic shock</subject><subject>Tomography</subject><subject>Tomography, X-Ray Computed - methods</subject><subject>Ureteral Obstruction - complications</subject><subject>Ureteral Obstruction - diagnostic imaging</subject><subject>Urinary tract</subject><subject>Urine</subject><subject>Urogenital system</subject><subject>Urology</subject><subject>Urology - Original Paper</subject><subject>Vasoconstrictor Agents - therapeutic use</subject><subject>Young Adult</subject><issn>0301-1623</issn><issn>1573-2584</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp1kUtLxDAUhYMoOj5-gBspuHFTvUmaplmJDL5AcKPrkKZ3nErb1CQV59-bYXyA4Oou7nfOPckh5JjCOQWQF4FSJkQOtMqpUipnW2RGheQ5E1WxTWbAgea0ZHyP7IfwCgCqAtglexw4FUVVzoidmyHDD-sxOr_KxqUJmFnXj1PEJouudy_ejMu08di0Nma1sRE99q3J2iFzdYh-srF9TyrT2alzU8jGFXZuwHHp29iGy0OyszBdwKOveUCeb66f5nf5w-Pt_fzqIbdcspjTxijZUGuUkkqyQoI0VPGKNdKqWlq2AF4azivLBRdy_eIFVgggrKhrafgBOdv4jt69TRii7ttgsevMgCmWZjRpWFkUkNDTP-irm_yQ0q2pqmQycYmiG8p6F4LHhR592xu_0hT0ugG9aUCnBvQ6j2ZJc_LlPNU9Nj-K7y9PANsAIa2GF_S_p_93_QR54ZGI</recordid><startdate>20181201</startdate><enddate>20181201</enddate><creator>Yagihashi, Yusuke</creator><creator>Shimabukuro, Shuichi</creator><creator>Toyosato, Tomotune</creator><creator>Arakaki, Yoshitaka</creator><general>Springer Netherlands</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7827-7339</orcidid></search><sort><creationdate>20181201</creationdate><title>Can excretory phase computed tomography predict bacteremia in obstructive calculous pyelonephritis?</title><author>Yagihashi, Yusuke ; Shimabukuro, Shuichi ; Toyosato, Tomotune ; Arakaki, Yoshitaka</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-1da97d1ca9979724707a19382d7c9b7c2f036a338c353571999fe8e005c5bb7a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Acute Disease</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Bacteremia</topic><topic>Bacteremia - etiology</topic><topic>Bacteremia - microbiology</topic><topic>Computed tomography</topic><topic>Female</topic><topic>Humans</topic><topic>Kidney Calculi - complications</topic><topic>Kidney Calculi - diagnostic imaging</topic><topic>Lithiasis</topic><topic>Male</topic><topic>Medical records</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Multivariate analysis</topic><topic>Nephrology</topic><topic>Predictive Value of Tests</topic><topic>Pyelonephritis</topic><topic>Pyelonephritis - diagnostic imaging</topic><topic>Pyelonephritis - etiology</topic><topic>Risk Factors</topic><topic>Sepsis</topic><topic>Septic shock</topic><topic>Tomography</topic><topic>Tomography, X-Ray Computed - methods</topic><topic>Ureteral Obstruction - complications</topic><topic>Ureteral Obstruction - diagnostic imaging</topic><topic>Urinary tract</topic><topic>Urine</topic><topic>Urogenital system</topic><topic>Urology</topic><topic>Urology - Original Paper</topic><topic>Vasoconstrictor Agents - therapeutic use</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yagihashi, Yusuke</creatorcontrib><creatorcontrib>Shimabukuro, Shuichi</creatorcontrib><creatorcontrib>Toyosato, Tomotune</creatorcontrib><creatorcontrib>Arakaki, Yoshitaka</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>International urology and nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yagihashi, Yusuke</au><au>Shimabukuro, Shuichi</au><au>Toyosato, Tomotune</au><au>Arakaki, Yoshitaka</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Can excretory phase computed tomography predict bacteremia in obstructive calculous pyelonephritis?</atitle><jtitle>International urology and nephrology</jtitle><stitle>Int Urol Nephrol</stitle><addtitle>Int Urol Nephrol</addtitle><date>2018-12-01</date><risdate>2018</risdate><volume>50</volume><issue>12</issue><spage>2123</spage><epage>2129</epage><pages>2123-2129</pages><issn>0301-1623</issn><eissn>1573-2584</eissn><abstract>Purpose
Acute pyelonephritis (AP), a complication of urolithiasis, can be fatal if it progresses to septic shock. We aimed to evaluate the performance of excretory phase computed tomography (CT) in predicting bacteremia among AP patients with upper urinary tract calculi.
Methods
We reviewed medical records of 250 patients diagnosed with AP and upper urinary tract calculi and who were admitted to our institute. We analyzed 132 patients who underwent excretory phase CT. Excretory phase CT images were obtained 7 min after injection with the contrast agent. Obstruction was classified either as high or low grade. Univariate and multivariate analyses were performed to identify the risk factors of bacteremia.
Results
Of 132 patients, 73 (55.3%) had bacteremia.
Escherichia coli
was the most frequently identified pathogen in blood cultures. Univariate analysis demonstrated that high-grade obstruction on excretory phase CT and quick Sepsis-related Organ Failure Assessment (qSOFA) score ≥ 2 were correlated with bacteremia. In addition, the administration of vasopressors was significantly associated with bacteremia (31.5% vs. 6.8%;
p
< 0.001). Multivariate analysis identified high-grade obstruction on excretory phase CT [odds ratio (OR) 6.68;
p
< 0.001] and qSOFA score ≥ 2 (OR 3.59,
p
= 0.03) as independent risk factors for bacteremia.
Conclusions
Excretory phase CT images can be used to predict bacteremia by evaluating the degree of ureteral obstruction. The evaluation of the passage of urine shown by excretory phase CT is critical in patients with AP associated with upper urinary tract calculi.</abstract><cop>Dordrecht</cop><pub>Springer Netherlands</pub><pmid>30315486</pmid><doi>10.1007/s11255-018-1999-2</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-7827-7339</orcidid></addata></record> |
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| subjects | Acute Disease Adult Aged Aged, 80 and over Bacteremia Bacteremia - etiology Bacteremia - microbiology Computed tomography Female Humans Kidney Calculi - complications Kidney Calculi - diagnostic imaging Lithiasis Male Medical records Medicine Medicine & Public Health Middle Aged Multivariate analysis Nephrology Predictive Value of Tests Pyelonephritis Pyelonephritis - diagnostic imaging Pyelonephritis - etiology Risk Factors Sepsis Septic shock Tomography Tomography, X-Ray Computed - methods Ureteral Obstruction - complications Ureteral Obstruction - diagnostic imaging Urinary tract Urine Urogenital system Urology Urology - Original Paper Vasoconstrictor Agents - therapeutic use Young Adult |
| title | Can excretory phase computed tomography predict bacteremia in obstructive calculous pyelonephritis? |
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