잠시만 기다려 주세요. 로딩중입니다.

일개 병원에서의 응급실을 방문한 패혈성 폐쇄성 요로감염 환자에 대한 고찰

A single emergency center study for obstructive urinary tract infection with sepsis

대한응급의학회지 2020년 31권 3호 p.267 ~ 274
박재형 ( Park Jae-Hyung ) - CHA University CHA Gumi Medical Center Department of Emergency Medicine

김성훈 ( Kim Seong-Hun ) - CHA University CHA Gumi Medical Center Department of Emergency Medicine
최마이클승필 ( Choe Michael Sung Pil ) - CHA University CHA Gumi Medical Center Department of Emergency Medicine
제동욱 ( Je Dong-Wook ) - CHA University CHA Gumi Medical Center Department of Emergency Medicine
노우영 ( Nho Woo-Young ) - CHA University CHA Gumi Medical Center Department of Emergency Medicine
박홍인 ( Park Hong-In ) - CHA University CHA Gumi Medical Center Department of Emergency Medicine
신수정 ( Shin Su-Jeong ) - CHA University CHA Gumi Medical Center Department of Emergency Medicine
박용석 ( Park Yong-Seok ) - CHA University CHA Gumi Medical Center Department of Emergency Medicine
박창원 ( Park Chang-Won ) - CHA University CHA Gumi Medical Center Department of Emergency Medicine
이미진 ( Lee Mi-Jin ) - Kyungpook National University School of Medicine Department of Emergency Medicine
안재윤 ( Ahn Jae-Yun ) - Kyungpook National University School of Medicine Department of Emergency Medicine
이동은 ( Lee Dong-Eun ) - Kyungpook National University School of Medicine Department of Emergency Medicine
문성배 ( Moon Sung-Bae ) - Kyungpook National University School of Medicine Department of Emergency Medicine
김창호 ( Kim Chang-Ho ) - Kyungpook National University School of Medicine Department of Emergency Medicine
이석희 ( Lee Suk-Hee ) - Daegu Catholic University School of Medicine Department of Emergency Medicine

Abstract


Objective: Unlike common acute urinary tract infections, obstructive urinary tract infections caused by urinary calculus can be fatal because they can progress to sepsis and cause shock or disseminated intravascular coagulation. The evidence of patients with obstructive urinary tract infections caused by urinary tract stones visiting the emergency center is still lacking.

Method:
Seventy-seven patients who visited the emergency room with obstructive urinary tract infections caused by urinary calculus from January 2016 to December 2018 were enrolled in this study and divided into two groups: sepsis group and non-sepsis group.

Results: The lymphocyte count, platelet count, neutrophil-lymphocyte ratio, serum creatinine, and C-reactive protein were significantly different in the sepsis-positive and negative groups. Percutaneous nephrostomy was also significantly higher in the sepsis-positive group. The area under the receiver operating characteristic curve was calculated to evaluate the ability of the neutrophil-lymphocyte ratio and platelet-lymphocyte ratio to predict a septic urinary tract infection. The neutrophil-lymphocyte ratio and platelet-lymphocyte ratio were 0.659 and 0.550, respectively. Multivariate logistic regression analysis showed that diabetic patients, percutaneous nephrostomy, and serum creatinine were associated with septic obstructive urinary tract infection.

Conclusion: In patients with an obstructive urinary tract infection who were referred to the emergency center, diabetic patients and those with high blood urea nitrogen and creatinine levels are at high risk of sepsis. In such cases, rapid diagnosis and treatment, such as percutaneous nephrostomy, are necessary.

키워드

Sepsis; Urinary tract infections; Urinary calculi
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