title: Risk factors of septic shock in bacteremic acute pyelonephritis patients admitted to an ER.
abstract: Our objective was to identify factors associated with septic shock in patients with bacteremic acute pyelonephritis who were admitted to our emergency department (ER). We performed a retrospective cohort study of 208 adult cases compiled between January 2000 and December 2010. The mean age of the 208 predominantly female (81.3%) adult cases enrolled during the study period was 65.9 ± 15.2 years. The overall mortality rate was 6.7% (14/208), but the mortality rate of 54 patients (26%, 54/208) who initially presented with shock was 25.9% (14/54). Multiple logistic regression analyses revealed that the independent risk factors for the occurrence of septic shock were the presence of a urinary tract obstruction (OR 4.391, 95% CI 1.782-10.821, P = 0.001), healthcare-associated infection (OR 3.491, 95% CI 1.585-7.692, P = 0.002), and liver cirrhosis (OR 4.609, 95% CI 1.395-15.222, P = 0.012). Therefore, physicians should be aware that appropriate early management is necessary to prevent fatal outcomes in patients with risk factors of septic shock.
authors.affiliation: Department of Internal Medicine, Wonkwang University College of Medicine, 344-2, Sinyong-dong, Iksan, 570-749, Republic of Korea. john7026@wku.ac.kr
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Lee
authors.forename: Yu Min
authors.initials: YM
authors.lastname: Lee
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Cho
mesh_terms: D000368:Aged; D016470:Bacteremia / Q000150:complications*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011704:Pyelonephritis / Q000382:microbiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012772:Shock, Septic / Q000382:microbiology*