INTRODUCTION: @entity2885 ( @entity2885 ) is a life-threatening necrotising @entity8 , but there is no consensus on the best management. METHODS: We systematically reviewed previous articles published from 1980 to 2013 that included studies reporting on @entity2885 , and applying the Cochrane guidelines, we conducted a meta-analysis of the results. RESULTS: In all, 32 studies were included, with results for 628 @entity1 (mean age 56.6  years, range 33.8-79.9). There were 462 @entity1 , outnumbering @entity1 by 3:1. @entity6 was present in 85% of the cases. Fevers and rigor (74.7%), @entity4658 (78.2%) and @entity158 (70.4%) were the most common symptoms. Shock was associated with 54.4% of @entity204 while obstructive @entity3551 was associated with 15.1% of @entity204 . Computed tomography was diagnostic in all the cases. @entity5173 ( @entity5173 ) and @entity910 ( @entity910 ) alone were associated with a significantly lower mortality rate than was emergency nephrectomy (EN), with an odds ratio (95% confidence interval) for @entity5173 vs. EN of 3.13 (1.89-5.16; P  <  0.001), for EN vs. @entity910 of 2.84 (1.62-4.99; P  =  0.001), and of 0.91 (0.53-1.56; P  =  0.73, i.e., no difference) for @entity5173 vs. @entity910 . Open drainage also had a significantly lower mortality rate than EN, with a ratio of 0.12 (0.02-0.91; P  <  0.04). CONCLUSION: The overall mortality rate was    18%; shock was associated with a high mortality rate and therefore should be managed aggressively. @entity5173 and @entity910 were associated with significantly higher survival rates than EN, and therefore EN should only be considered if the @entity1 does not improve despite other treatments.

XXXX : Time for a management plan with an evidence-based approach.

@entity1 :: ('9606', 'Species') :: ['women', 'patients', 'patient', 'men'] @entity4658 :: ('MESH:D011776', 'Disease') :: ['pyuria'] @entity8 :: ('MESH:D007674', 'Disease') :: ['kidney infection'] @entity3551 :: ('MESH:C536483', 'Disease') :: ['uropathy'] @entity6 :: ('MESH:D003920', 'Disease') :: ['Diabetes'] @entity910 :: ('MESH:D004409', 'Disease') :: ['medical management', 'MM'] @entity5173 :: ('MESH:D065634', 'Disease') :: ['PCD', 'Percutaneous drainage'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain'] @entity2885 :: ('MESH:D011704', 'Disease') :: ['Emphysematous pyelonephritis', 'EPN'] @entity204 :: ('MESH:D003643', 'Disease') :: ['deaths']
@entity2885 :: (MESH:D011704,Disease) :: ['Emphysematous pyelonephritis']
