Urogenit Tract Infect.
2025 Apr;20(1):34-41. 10.14777/uti.2550006003.
Mortality and Risk Factors for Emphysematous Pyelonephritis in Korea: A Multicenter Retrospective Cohort Study
- Choi SK
1 - Lee JW2
- Jung SI3
- Hwang EC3
- Choi J4
- Kim WB5
- Huh JS6
- Choi JB7
- Kim Y8
- Chung JM9
- Shin JH10
- Jung JH11
- Chung H11
- Bae S12
- Kim TH13
- Affiliations
-
- 1Department of Urology, Seoul Medical Center, Seoul, Korea
- 2Department of Urology, Kyung Hee University College of Medicine, Seoul, Korea
- 3Department of Urology, Chonnam National University Medical School, Gwangju, Korea
- 4Department of Urology, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong, Korea
- 5Department of Urology, Soonchunhyang University College of Medicine, Cheonan, Korea
- 6Department of Urology, Jeju National University College of Medicine, Jeju, Korea
- 7Department of Urology, The Catholic University of Korea College of Medicine, Seoul, Korea
- 8Department of Urology, Daegu Fatima Hospital, Daegu, Korea
- 9Department of Urology, Pusan National University Yangsan Hospital, Yangsan, Korea
- 10Department of Urology, Chungnam National University College of Medicine, Daejeon, Korea
- 11Department of Urology, Yonsei University Wonju College of Medicine, Wonju, Korea
- 12Department of Urology, Uijeongbu St. Mary’ Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
- 13Department of Urology, Chung-Ang University College of Medicine, Seoul, Korea
- KMID: 2567661
- DOI: http://doi.org/10.14777/uti.2550006003
Abstract
- Purpose
Emphysematous pyelonephritis (EPN) is a life-threatening disease requiring immediate treatment. This multicenter retrospective cohort study aimed to analyze the mortality rate and risk factors associated with EPN.
Materials and Methods
Between January 2011 and February 2021, 217 patients diagnosed with EPN via computed tomography who visited 14 teaching hospitals were retrospectively analyzed. Clinical data, including age, sex, comorbidities, Huang and Tseng classification, hydronephrosis, acute kidney injury, blood and urine tests, surgical interventions, percutaneous drainage, and conservative treatments, were compared between the survival and death groups. Risk factors for mortality due to EPN were analyzed using univariate and multivariate methods.
Results
The mean age of survivors and deceased patients was 67.8 and 69.0 years, respectively (p=0.136). The sex distribution (male/female) was 48/146 and 8/15, respectively (p=0.298). Of the 217 patients, 23 died, resulting in a mortality rate of 10.6%. In univariate analysis, the Huang and Tseng classification (p=0.004), platelet count (p=0.005), and acute kidney injury (p=0.007) were significantly associated with mortality from EPN. In multivariate analysis, only the Huang and Tseng classification (p=0.029) was identified as a risk factor. Mortality rates according to the Huang and Tseng classification were as follows: class I (5.88%), class II (7.50%), class IIIa (14.28%), class IIIb (25.00%), and class IV (23.07%).
Conclusions
EPN is associated with a high mortality rate. Among various clinical factors, the Huang and Tseng classification was the most significant indicator for predicting mortality.
