J Korean Soc Emerg Med.  2014 Aug;25(4):463-470. 10.0000/jksem.2014.25.4.463.

Availability of hs-C-reactive protein as Predictive Value of Acute Pyelonephritis with Patient of Urolithiasis

• Park JW
• Jin SC
• Kim SJ
• Choi WI

• KMID: 2333903
• DOI: http://doi.org/10.0000/jksem.2014.25.4.463

Abstract

PURPOSE
The aim of this study was to determine early predictive value of acute pyelonephritis and urosepsis in patients with urolithiasis in the emergency department.
METHODS
We retrospectively reviewed medical records of patients who visited the emergency department and were diagnosed with urolithiasis by computed tomography for three years. Patients with urolithiasis were grouped according to the presence of computed tomography (CT) findings with acute pyelonephritis. In baseline characteristics, laboratory and CT findings of the two groups were compared. Group 1 was defined as urolithiasis without acute pyelonephritis and group 2 was defined as urolithiasis with acute pyelonephritis. In addition, we compared the sepsis versus 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 acute pyelonephritis in CT findings. Age, sex, history of diabetes, history of urolithiasis, size of stone, duration of symptom, body temperature, blood pressure, heart rate, respiratory rate, leukocyte count, existence of pyuria, and hs-CRP differed significantly between the two groups, respectively. In multivariate logistic regression analysis, age, history of urolithiasis, existence of pyuria, and hs-CRP were shown to be independent predictors affecting acute pyelonephritis in patients with urolithiasis. The area under the receiving operator characteristics (ROC) curve for CRP was 0.820 (95% CI, 0.754-0.886) and leukocyte count was 0.631 [95% confidence interval (CI), 0.542-0.721]. Sepsis and PCN groups showed significantly higher hs-CRP level than non-sepsis and non-PCN groups.
CONCLUSION
There were some independent predictive values of urolithiasis with acute pyelonephritis. It can be useful in early detection of acute pyelonephritis or sepsis, and it can be helpful in making treatment plans for patients of urolithiasis.

Keyword

Urolithiasis; Pyelonephritis; C-reactive protein

MeSH Terms

Blood Pressure
Body Temperature
C-Reactive Protein
Emergency Service, Hospital
Heart Rate
Humans
Leukocyte Count
Logistic Models
Medical Records
Nephrostomy, Percutaneous
Pregnenolone Carbonitrile
Pyelonephritis*
Pyuria
Respiratory Rate
Retrospective Studies
Sepsis
Staphylococcal Protein A*
Urolithiasis*
C-Reactive Protein
Pregnenolone Carbonitrile
Staphylococcal Protein A