Factors Associated To Intensive Care Admission And Mortality In Patients With Emphysematous Pyelonephritis

Study Overview
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Brief Summary
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Emphysematous pyelonephritis is a lifethreatening necrotizing infection of the kidney characterized by accumulation of gas in the renal parenchyma and within the surrounding tissues. The aim of the study is to report the outcome of the management of this condition at the investigators institution and to determine the microbiological characteristics, antibiotic resistance patterns, and to analyze factors predicting mortality and intensive care unit admission.

Detailed Description
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The investigators are planning to perform a retrospective study analyzing cases of emphysematous pyelonephritis from a single tertiary care institution in the north of Mexico in the period of 2011-2021. The diagnosis of emphysematous pyelonephritis is confirmed by computed tomography. Demographic, clinical, biochemical, therapeutic management, and outcomes will be collected. Variables will be analyzed to determine factors associated with admission to intensive care unit and mortality. Urine cultures will be analyzed and drug resistance profile will be determined using microdilution plate. Clinical and demographic characteristics will be analyzed using Chi square test for categorical variables, and T-test for numerical variables. Statistical significance is set at p<0.05. Statistical analysis will be performed with the SPSS software version 20.0.

Official Title
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Microbiologic Profile And Factors Associated To Intensive Care Admission And Mortality In Patients With Emphysematous Pyelonephritis: A 10-Year Experience In A Tertiary Care Center

Conditions
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Emphysematous Pyelonephritis

Intervention / Treatment
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* Procedure: Nephrectomy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Emphysematous pyelonephritis confirmed with computed tomography Systemic inflammatory response Urinary tract infection symptoms Complete medical records Both genders included >18 years old Exclusion Criteria: Other infectious causes Asymptomatic bacteriuria Incomplete medical records Endourologic procedure 3 months before recruitment

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Emphysematous pyelonephritis<br>This is a single-group cohort study. A sub-classification will be used in order to differentiate patients that did not require intensive care, the ones who admitted to intensive care and mortality. | Procedure: Nephrectomy<br>* Different therapeutic options are described in literature for emphysematous pyelonephritis. In our center, medical treatment (no invasive procedure), ureteral stent (endourologic procedure), percutaneous drainage (minimally invasive procedure), and nephrectomy are the therapeutic options for this disease.<br>* Other names: medical treatment;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of patients with admission to Intensive care unit | Patients with criteria to admit to intensive care unit | 10 years | 
| Rate of mortality | Death cases during hospitalization | 10 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Antibiotic susceptibility | Drug resistance profile will be determined using microdilution plate. | 10 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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emphysematous pyelonephritis, intensive care unit, mortality, risk factors