A novel mortality risk score for emphysematous pyelonephritis: A multicenter study of the Global Research in the Emphysematous Pyelonephritis group
Abstract. Background. Emphysematous pyelonephritis (EPN) is a necrotizing infection of the kidney and the surrounding tissues associated with considerable mortality. We aimed to formulate a score that classifies the risk of mortality in patients with EPN at hospital admission. Materials and methods....
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Wolters Kluwer Health
2024-03-01
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| Series: | Current Urology |
| Online Access: | http://journals.lww.com/10.1097/CU9.0000000000000163 |
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| author | Hegel Trujillo-Santamaría José Iván Robles-Torres Jeremy Yuen-Chun Teoh Yiloren Tanidir José Gadú Campos-Salcedo Edgar Iván Bravo-Castro Marcelo Langer Wroclawski W. S. Yeoh Santosh Kumar Juan Eduardo Sanchez-Nuñez José Enrique Espinoza-Aznar Deepak Ragoori Saeed Bin Hamri Ong Teng Aik Cecil Paul Tarot-Chocooj Anil Shrestha Mohamed Amine Lakmichi Mateus Cosentino-Bellote Luis Gabriel Vázquez-Lavista Boukary Kabre Ho Yee Tiong José Gustavo Arrambide-Herrera Lauro Salvador Gómez-Guerra Umut Kutukoglu Joao Arthur Brunhara Alves-Barbosa Jorge Jaspersen Christian Acevedo Francisco Virgen-Gutiérrez Sumit Agrawal Hugo Octaviano Duarte-Santos Chai Chu Ann Daniele Castellani Vineet Gahuar |
| author_facet | Hegel Trujillo-Santamaría José Iván Robles-Torres Jeremy Yuen-Chun Teoh Yiloren Tanidir José Gadú Campos-Salcedo Edgar Iván Bravo-Castro Marcelo Langer Wroclawski W. S. Yeoh Santosh Kumar Juan Eduardo Sanchez-Nuñez José Enrique Espinoza-Aznar Deepak Ragoori Saeed Bin Hamri Ong Teng Aik Cecil Paul Tarot-Chocooj Anil Shrestha Mohamed Amine Lakmichi Mateus Cosentino-Bellote Luis Gabriel Vázquez-Lavista Boukary Kabre Ho Yee Tiong José Gustavo Arrambide-Herrera Lauro Salvador Gómez-Guerra Umut Kutukoglu Joao Arthur Brunhara Alves-Barbosa Jorge Jaspersen Christian Acevedo Francisco Virgen-Gutiérrez Sumit Agrawal Hugo Octaviano Duarte-Santos Chai Chu Ann Daniele Castellani Vineet Gahuar |
| author_sort | Hegel Trujillo-Santamaría |
| collection | DOAJ |
| description | Abstract. Background. Emphysematous pyelonephritis (EPN) is a necrotizing infection of the kidney and the surrounding tissues associated with considerable mortality. We aimed to formulate a score that classifies the risk of mortality in patients with EPN at hospital admission.
Materials and methods. Patients diagnosed with EPN between 2013 and 2020 were retrospectively included. Data from 15 centers (70%) were used to develop the scoring system, and data from 7 centers (30%) were used to validate it. Univariable and multivariable logistic regression analyses were performed to identify independent factors related to mortality. Receiver operating characteristic curve analysis was performed to construct the scoring system and calculate the risk of mortality. A standardized regression coefficient was used to quantify the discriminating power of each factor to convert the individual coefficients into points. The area under the curve was used to quantify the scoring system performance. An 8-point scoring system for the mortality risk was created (range, 0–7).
Results. In total, 570 patients were included (400 in the test group and 170 in the validation group). Independent predictors of mortality in the multivariable logistic regression were included in the scoring system: quick Sepsis-related Organ Failure Assessment score ≥2 (2 points), anemia, paranephric gas extension, leukocyte count >22,000/μL, thrombocytopenia, and hyperglycemia (1 point each). The mortality rate was <5% for scores ≤3, 83.3% for scores 6, and 100% for scores 7. The area under the curve was 0.90 (95% confidence interval, 0.84–0.95) for test and 0.91 (95% confidence interval, 0.84–0.97) for the validation group.
Conclusions. Our score predicts the risk of mortality in patients with EPN at presentation and may help clinicians identify patients at a higher risk of death. |
| format | Article |
| id | doaj-art-8ff726e6041c4f3ca1b7b36ba966f09d |
| institution | DOAJ |
| issn | 1661-7649 1661-7657 |
| language | English |
| publishDate | 2024-03-01 |
| publisher | Wolters Kluwer Health |
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| series | Current Urology |
| spelling | doaj-art-8ff726e6041c4f3ca1b7b36ba966f09d2025-08-20T03:06:20ZengWolters Kluwer HealthCurrent Urology1661-76491661-76572024-03-01181556010.1097/CU9.0000000000000163202403000-00011A novel mortality risk score for emphysematous pyelonephritis: A multicenter study of the Global Research in the Emphysematous Pyelonephritis groupHegel Trujillo-Santamaría0José Iván Robles-Torres1Jeremy Yuen-Chun Teoh2Yiloren Tanidir3José Gadú Campos-Salcedo4Edgar Iván Bravo-Castro5Marcelo Langer Wroclawski6W. S. Yeoh7Santosh Kumar8Juan Eduardo Sanchez-Nuñez9José Enrique Espinoza-Aznar10Deepak Ragoori11Saeed Bin Hamri12Ong Teng Aik13Cecil Paul Tarot-Chocooj14Anil Shrestha15Mohamed Amine Lakmichi16Mateus Cosentino-Bellote17Luis Gabriel Vázquez-Lavista18Boukary Kabre19Ho Yee Tiong20José Gustavo Arrambide-Herrera21Lauro Salvador Gómez-Guerra22Umut Kutukoglu23Joao Arthur Brunhara Alves-Barbosa24Jorge Jaspersen25Christian Acevedo26Francisco Virgen-Gutiérrez27Sumit Agrawal28Hugo Octaviano Duarte-Santos29Chai Chu Ann30Daniele Castellani31Vineet Gahuar32a Department of Urology, Hospital Covadonga, Córdoba, Méxicob Department of Urology, Hospital Universitario “Dr. José Eleuterio Gonzalez”, Monterrey, Méxicoc Department of Surgery, S.H. Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Chinad Department of Urology, Marmara University School of Medicine, Istanbul, Turkeye Department of Urology, Hospital Central Militar, México City, Méxicoe Department of Urology, Hospital Central Militar, México City, Méxicof Department of Urology, Hospital Israelita Albert Einstein, BP-a Beneficência Portuguesa de São Paulo, Sao Paulo, Brazilh Department of Urology, University Surgical Cluster, National University Hospital, Singapore, Singaporei Department Urology, Christian Medical College, Vellore, Tamilnad, Indiaj Department Urology, Hospital General de México “Dr. Eduardo Liceaga”, México City, Méxicok Department of Urology, Hospital Regional de Alta Especialidad de la Peninsula de Yucatán, Mérida, Méxicol Department Urology, Asian Institute of Nephrology and Urology, Hyderabad, Indiam Department Urology, King Abdulaziz National Guard Hospital, Riyadh, Saudi Arabian Division of Urology, Department of Surgery, University of Malaya, Kuala Lumpur, Malaysiao Department of Urology, Central Military Hospital, Mexico City, Mexicop National Academy of Medical Sciences, Bir Hospital and B&B Hospital, Gwarko Lalitpur, Nepalq Department of Urology, University Hospital Mohammed the VIth of Marrakesh, Marrakesh, Morocco r Department of Urology, Federal University of Paraná, School of Medicine, Hospital das Clínicas, Curitiba, Brazils Department of Urology, Hospital Médica Sur, Mexico City, Mexicot Department of Urology, Hospital Yalgado Ouedraogo Ouagadouga, Kadiogo, Burkina Fasoh Department of Urology, University Surgical Cluster, National University Hospital, Singapore, Singaporeb Department of Urology, Hospital Universitario “Dr. José Eleuterio Gonzalez”, Monterrey, Méxicob Department of Urology, Hospital Universitario “Dr. José Eleuterio Gonzalez”, Monterrey, Méxicod Department of Urology, Marmara University School of Medicine, Istanbul, Turkeyu Department of Urology, Hospital Das Clínicas da Universidade de São Paulo, Sao Paulo, Brazilj Department Urology, Hospital General de México “Dr. Eduardo Liceaga”, México City, Méxicoj Department Urology, Hospital General de México “Dr. Eduardo Liceaga”, México City, Méxicoj Department Urology, Hospital General de México “Dr. Eduardo Liceaga”, México City, Méxicov Department of Urology, AIIMS, Bhubaneshwar, Indiaw Department of Urology, Hospital Municipal Dr. Moysés Deutsch (M’Boi Mirim), Sao Paulo, Braziln Division of Urology, Department of Surgery, University of Malaya, Kuala Lumpur, Malaysiax Department of Urology, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Polytechnic University of Le Marche Region, Ancona, Italyy Department of Minimally Invasive Urology, Ng Teng Fong General Hospital, Singapore, SingaporeAbstract. Background. Emphysematous pyelonephritis (EPN) is a necrotizing infection of the kidney and the surrounding tissues associated with considerable mortality. We aimed to formulate a score that classifies the risk of mortality in patients with EPN at hospital admission. Materials and methods. Patients diagnosed with EPN between 2013 and 2020 were retrospectively included. Data from 15 centers (70%) were used to develop the scoring system, and data from 7 centers (30%) were used to validate it. Univariable and multivariable logistic regression analyses were performed to identify independent factors related to mortality. Receiver operating characteristic curve analysis was performed to construct the scoring system and calculate the risk of mortality. A standardized regression coefficient was used to quantify the discriminating power of each factor to convert the individual coefficients into points. The area under the curve was used to quantify the scoring system performance. An 8-point scoring system for the mortality risk was created (range, 0–7). Results. In total, 570 patients were included (400 in the test group and 170 in the validation group). Independent predictors of mortality in the multivariable logistic regression were included in the scoring system: quick Sepsis-related Organ Failure Assessment score ≥2 (2 points), anemia, paranephric gas extension, leukocyte count >22,000/μL, thrombocytopenia, and hyperglycemia (1 point each). The mortality rate was <5% for scores ≤3, 83.3% for scores 6, and 100% for scores 7. The area under the curve was 0.90 (95% confidence interval, 0.84–0.95) for test and 0.91 (95% confidence interval, 0.84–0.97) for the validation group. Conclusions. Our score predicts the risk of mortality in patients with EPN at presentation and may help clinicians identify patients at a higher risk of death.http://journals.lww.com/10.1097/CU9.0000000000000163 |
| spellingShingle | Hegel Trujillo-Santamaría José Iván Robles-Torres Jeremy Yuen-Chun Teoh Yiloren Tanidir José Gadú Campos-Salcedo Edgar Iván Bravo-Castro Marcelo Langer Wroclawski W. S. Yeoh Santosh Kumar Juan Eduardo Sanchez-Nuñez José Enrique Espinoza-Aznar Deepak Ragoori Saeed Bin Hamri Ong Teng Aik Cecil Paul Tarot-Chocooj Anil Shrestha Mohamed Amine Lakmichi Mateus Cosentino-Bellote Luis Gabriel Vázquez-Lavista Boukary Kabre Ho Yee Tiong José Gustavo Arrambide-Herrera Lauro Salvador Gómez-Guerra Umut Kutukoglu Joao Arthur Brunhara Alves-Barbosa Jorge Jaspersen Christian Acevedo Francisco Virgen-Gutiérrez Sumit Agrawal Hugo Octaviano Duarte-Santos Chai Chu Ann Daniele Castellani Vineet Gahuar A novel mortality risk score for emphysematous pyelonephritis: A multicenter study of the Global Research in the Emphysematous Pyelonephritis group Current Urology |
| title | A novel mortality risk score for emphysematous pyelonephritis: A multicenter study of the Global Research in the Emphysematous Pyelonephritis group |
| title_full | A novel mortality risk score for emphysematous pyelonephritis: A multicenter study of the Global Research in the Emphysematous Pyelonephritis group |
| title_fullStr | A novel mortality risk score for emphysematous pyelonephritis: A multicenter study of the Global Research in the Emphysematous Pyelonephritis group |
| title_full_unstemmed | A novel mortality risk score for emphysematous pyelonephritis: A multicenter study of the Global Research in the Emphysematous Pyelonephritis group |
| title_short | A novel mortality risk score for emphysematous pyelonephritis: A multicenter study of the Global Research in the Emphysematous Pyelonephritis group |
| title_sort | novel mortality risk score for emphysematous pyelonephritis a multicenter study of the global research in the emphysematous pyelonephritis group |
| url | http://journals.lww.com/10.1097/CU9.0000000000000163 |
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