title: [Prognostic factors of morbimortality in patients with emphysematous pyelonephritis].
abstract: BACKGROUND
  Emphysematous pyelonephritis (EPN) is a severe infection of the urinary tract, caused by gas accumulation within the collecting system, the renal parenchyma, and/or the perirenal tissue. The cause of this infection is not known at all; however, it has been suggested that it is produced by the glucose fermentation provoked by enterobacteriaceae or anaerobic organisms. Our objective was to evaluate the predictors of morbidity and mortality in patients diagnosed with EPN.
  
  
  METHODS
  It was carried out a historical cohort study of patients diagnosed with EPN in our hospital from March 2005 to December 2014. Patients with adverse outcome were identified. We defined adverse outcome as patients requiring stay in intensive care unit, who presented nephrectomy and/or who died. A multiple regression analysis was conducted to establish the relation of each clinical factor with the adverse outcome.
  
  
  RESULTS
  73 records were included for analysis, 48 were women (65.8 %) and 25 men. Diabetes, urolithiasis, E. coli infection and septic shock occurred in 68.5, 68.5, 63, and 15.1 %, respectively. We found that leukocytosis ≥12 000 µl (OR 43.65, 95 % CI 2.36-805, p <0.001), thrombocytopenia ≤120 000 µl (OR 363, 95 % 9.2-14208, p <0.0001), and Huang's radiological class 3 (OR 62, 95 % CI 4-964, p < 0.001) were factors significantly associated with adverse outcome.
  
  
  CONCLUSIONS
  Thrombocytopenia, leukocytosis and Huang's radiological class 3 are associated with adverse outcome in patients with EPN.
authors: Servicio de Urología, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México. jorgemorenomd@gmail.com.
authors: León Octavio
authors: LO
authors: Torres-Mercado
authors: Miguel Ángel
authors: MÁ
authors: García-Padilla
authors: Eduardo
authors: E
authors: Serrano-Brambila
authors: Efraín
authors: E
authors: Maldonado-Alcaraz
authors: Virgilio Augusto
authors: VA
authors: López-Sámano
authors: Guillermo
authors: G
authors: Montoya-Martínez
authors: Jorge
authors: J
authors: Moreno-Palacios
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003422:Critical Care; D004646:Emphysema / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011379:Prognosis; D011704:Pyelonephritis / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Pyelonephritis; Urinary tract; Urologic diseases