Urogenit Tract Infect.  2021 Aug;16(2):49-54. 10.14777/uti.2021.16.2.49.

Characteristics and Treatment Trends for Emphysematous Pyelonephritis in Korea: A 10-Year Multicenter Retrospective Study

Affiliations
  • 1Department of Urology, Seoul Medical Center, Seoul, Korea
  • 2Department of Urology, College of Medicine, Kyung Hee University, Seoul, Korea
  • 3Department of Urology, Dongguk University College of Medicine, Gyeongju, Korea
  • 4Department of Urology, Chonnam National University Medical School, Gwangju, Korea
  • 5Department of Urology, VHS Medical Center, Seoul, Korea
  • 6Department of Urology, Soonchunhyang University College of Medicine, Bucheon, Korea
  • 7Department of Urology, Jeju National University College of Medicine, Jeju, Korea
  • 8Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
  • 9Department of Urology, Daegu Fatima Hospital, Daegu, Korea
  • 10Department of Urology, Pusan National University Yangsan Hospital, Yangsan, Korea
  • 11Department of Urology, Chungnam National University College of Medicine, Daejeon, Korea
  • 12Department of Urology, Yonsei University Wonju College of Medicine, Wonju, Korea
  • 13Department of Urology, Konkuk University School of Medicine, Chungju, Korea
  • 14Department of Urology, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
  • 15Department of Urology, Chung-Ang University College of Medicine, Seoul, Korea

Abstract

Purpose
This study examined the characteristics, current treatment trends, and outcomes of patients with emphysematous pyelonephritis (EPN) in Korea.
Materials and Methods
Two hundred and seventeen patients diagnosed with EPN were evaluated using abdominal computed tomography in 2011-2021 at 15 institutes in Korea. The patients’ demographic and clinical characteristics, treatment modalities, and treatment outcomes were analyzed. The total study period was divided arbitrarily into groups A (2011-2014), B (2015-2017), and C (2018-2021) to analyze the trends in the EPN treatment.
Results
The mean age of the patients was 65.1 years; there were more female patients (74.2%) than male patients. The overall mortality rate was 10.6%. Ninety-five (43.8%), 98 (45.2%), and 24 (11.0%) patients were treated with medical, minimally invasive, and surgical management, respectively; the corresponding mortality rates were 13.7%, 6.1%, and 16.7%. There was no significant change in the proportion of patients treated with medical management over time (group A=46.5%, group B=47.0%, and group C=38.8%). The proportion of patients treated with minimally invasive management gradually increased over time (group A=35.2%; group B=43.9%; group C=55.0%), while those who underwent surgical management decreased gradually over time (group A=18.3%, group B=9.1%, and group C=6.3%). No differences in mortality rates were observed between the groups.
Conclusions
EPN with medical and minimally invasive management had a relatively high treatment success rate, which increased gradually, while surgical management decreased gradually over time in Korea. The mortality rate was relatively lower than that reported in studies published before the 2010s.

Keyword

Pyelonephritis; Therapeutics; Treatment outcome; Mortality; Republic of Korea
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