J Korean Soc Emerg Med.  2016 Aug;27(4):320-327. 10.0000/jksem.2016.27.4.320.

Comparison of Clinical Feature and Prognosis between Unilateral and Bilateral Acute Pyelonephritis

• Kim HW
• Ryoo SM
• Ahn S
• Sohn CH
• Seo DW
• Lee YS
• Lee JH
• Oh BJ
• Lim KS
• Kim WY

• KMID: 2350884
• DOI: http://doi.org/10.0000/jksem.2016.27.4.320

Abstract

PURPOSE
Acute pyelonephritis (APN) usually presents as a mild disease. However, it has been shown to cause substantial morbidity and mortality on occasion. Therefore, it is important to distinguish between the complicated and uncomplicated APN. The purpose of this study was to determine the clinical significance of bilateral APN compared with unilateral APN in the emergency department (ED).
METHODS
We analyzed the data of 303 consecutive patients with APN who underwent a abdominal computed tomography (CT) examination in the ED from January 2012 to December 2014. We compared the clinical presentation, progress, and outcomes between the unilateral and bilateral APNs that were identified on the CT scan.
RESULTS
Of these 303 patients, 110 patients (36.3%) were confirmed as bilateral APN by the CT. The proportion of male was higher in the bilateral APN group (20.0% vs. 10.9%, p=0.029). Moreover, patients in the bilateral group visited the ED post symptom onset (6.5±7.8 vs. 3.6±3.1, p<0.001). However, symptom, sign, laboratory test, and CT findings were not statistically different between the two groups. In addition, severity, resistant pathogen, and outcomes such as occurrence of septic shock, hospital days, and mortality were also not different.
CONCLUSION
This study suggests that bilateral APN, as determined by a CT, does not have clinical significance compared with unilateral APN.

Keyword

Emergency service; Hospital; Pyelonephritis; Tomography; X-Ray computed

MeSH Terms

Emergency Service, Hospital
Humans
Male
Mortality
Prognosis*
Pyelonephritis*
Shock, Septic
Tomography, X-Ray Computed