요로 결석 환자에서 급성 신우신염의 예측인자로 hs-C-reactive protein의 유용성 (Availability of hs-C-reactive protein as Predictive Value of Acute Pyelonephritis with Patient of Urolithiasis)

서지정보

· 발행기관 : 대한응급의학회
· 수록지 정보 : 대한응급의학회지 / 25권 / 4호 / 463 ~ 470페이지
· 저자명 : 박진욱, 진상찬, 김성진, 최우익

초록

Purpose: The aim of this study was to determine early predictivevalue of acute pyelonephritis and urosepsis inpatients with urolithiasis in the emergency department.
Methods: We retrospectively reviewed medical records ofpatients who visited the emergency department and werediagnosed with urolithiasis by computed tomography forthree years. Patients with urolithiasis were grouped accordingto the presence of computed tomography (CT) findingswith acute pyelonephritis. In baseline characteristics, laboratoryand CT findings of the two groups were compared.
Group 1 was defined as urolithiasis without acutepyelonephritis and group 2 was defined as urolithiasis withacute pyelonephritis. In addition, we compared the sepsisversus non-sepsis and percutaneous nephrostomy (PCN)versus non-PCN group in Group 2 for analysis of the hs-CRP level of each group.
Results: The total number of urolithiasis patients was 744.
Among the patients, 84 (11.3%) had urolithiasis with acutepyelonephritis in CT findings. Age, sex, history of diabetes,history of urolithiasis, size of stone, duration of symptom,body temperature, blood pressure, heart rate, respiratoryrate, leukocyte count, existence of pyuria, and hs-CRP differedsignificantly between the two groups, respectively. Inmultivariate logistic regression analysis, age, history ofurolithiasis, existence of pyuria, and hs-CRP were shown tobe independent predictors affecting acute pyelonephritis inpatients with urolithiasis. The area under the receiving operatorcharacteristics (ROC) curve for CRP was 0.820 (95%CI, 0.754-0.886) and leukocyte count was 0.631 [95% confidenceinterval (CI), 0.542-0.721]. Sepsis and PCN groupsshowed significantly higher hs-CRP level than non-sepsisand non-PCN groups.
Conclusion: There were some independent predictive valuesof urolithiasis with acute pyelonephritis. It can be usefulin early detection of acute pyelonephritis or sepsis, and itcan be helpful in making treatment plans for patients ofurolithiasis.

영어초록

Purpose: The aim of this study was to determine early predictivevalue of acute pyelonephritis and urosepsis inpatients with urolithiasis in the emergency department.
Methods: We retrospectively reviewed medical records ofpatients who visited the emergency department and werediagnosed with urolithiasis by computed tomography forthree years. Patients with urolithiasis were grouped accordingto the presence of computed tomography (CT) findingswith acute pyelonephritis. In baseline characteristics, laboratoryand CT findings of the two groups were compared.
Group 1 was defined as urolithiasis without acutepyelonephritis and group 2 was defined as urolithiasis withacute pyelonephritis. In addition, we compared the sepsisversus non-sepsis and percutaneous nephrostomy (PCN)versus non-PCN group in Group 2 for analysis of the hs-CRP level of each group.
Results: The total number of urolithiasis patients was 744.
Among the patients, 84 (11.3%) had urolithiasis with acutepyelonephritis in CT findings. Age, sex, history of diabetes,history of urolithiasis, size of stone, duration of symptom,body temperature, blood pressure, heart rate, respiratoryrate, leukocyte count, existence of pyuria, and hs-CRP differedsignificantly between the two groups, respectively. Inmultivariate logistic regression analysis, age, history ofurolithiasis, existence of pyuria, and hs-CRP were shown tobe independent predictors affecting acute pyelonephritis inpatients with urolithiasis. The area under the receiving operatorcharacteristics (ROC) curve for CRP was 0.820 (95%CI, 0.754-0.886) and leukocyte count was 0.631 [95% confidenceinterval (CI), 0.542-0.721]. Sepsis and PCN groupsshowed significantly higher hs-CRP level than non-sepsisand non-PCN groups.
Conclusion: There were some independent predictive valuesof urolithiasis with acute pyelonephritis. It can be usefulin early detection of acute pyelonephritis or sepsis, and itcan be helpful in making treatment plans for patients ofurolithiasis.

참고자료

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