Characteristics and Treatment Trends for Emphysematous Pyelonephritis in Korea: A 10-Year Multicenter Retrospective Study
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
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.
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.
참고문헌 (19)
- Huang JJ, "Emphysematous pyelonephritis : clinicoradiological classification, management, prognosis, and pathogenesis", Arch Intern Med, 160, pp.797~805 (2000)
- Kelly HA, "Pneumaturia", JAMA, 31, pp.375~381 (1898)
- Schultz EH Jr, "Emphysematous pyelonephritis", J Urol, 87, pp.762~766 (1962)
- Tang HJ, "Clinical characteristics of emphysematous pyelonephritis", J Microbiol Immunol Infect, 34, pp.125~130 (2001)
- Chuang YW, "Severe emphysematous pyelonephritis in a renal allograft : successful treatment with percutaneous drainage and antibiotics", Clin Nephrol, 68, pp.42~46 (2007)
- Pontin AR, "Emphysematous pyelonephritis in diabetic patients", Br J Urol, 75, pp.71~74 (1995)
- Turney JH, "Renal conservation for gas-forming infections", Lancet, 355, pp.770~771 (2000)
- Kamaliah MD, "Emphysematous pyelonephritis caused by Candida infection", Southeast Asian J Trop Med Public Health, 36, pp.725~727 (2005)
- Michaeli J, "Emphysematous pyelonephritis", J Urol, 131, pp.203~208 (1984)
- Chen MT, "Percutaneous drainage in the treatment of emphysematous pyelonephritis : 10-year experience", J Urol, 157, pp.1569~1573 (1997)
- Uruc F, "Emphysematous pyelonephritis : our experience in managing these cases", Can Urol Assoc J, 9, pp.E480~E483 (2015)
- Aboumarzouk OM, "Emphysematous pyelonephritis : time for a management plan with an evidence-based approach", Arab J Urol, 12, pp.106~115 (2014)
- NanaGR, "Nephroureterectomy for emphysematous pyelonephritis: an aggressive approach is sometimes necessary. A case report and literature review", Int J Surg Case Rep, 10, pp.179~182 (2015)
- Singer M, "The third international consensus definitions for sepsis and septic shock(sepsis-3)", JAMA, 315, pp.801~810 (2016)
- Falagas ME, "Risk factors for mortality in patients with emphysematous pyelonephritis : a meta-analysis", J Urol, 178(3 Pt 1), pp.880~885
- Lu YC, "Emphysematous pyelonephritis : clinical characteristics and prognostic factors", Int J Urol, 21, pp.277~282 (2014)
- Klein FA, "Emphysematous pyelonephritis : diagnosis and treatment", South Med J, 79, pp.41~46 (1986)
- Somani BK, "Is percutaneous drainage the new gold standard in the management of emphysematous pyelonephritis? Evidence from a systematic review", J Urol, 179, pp.1844~1849 (2008)
- Karthikeyan VS, "Clinical profile and successful outcomes of conservative and minimally invasive treatment of emphysematous pyelonephritis", Cent European J Urol, 71, pp.228~233 (2018)