1. Pain intensity and imaging at the initial phase of acute pyelonephritis
- Author
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L. Beuzit, J. Bouget, Matthieu Revest, Pierre Tattevin, Benoit Peyronnet, D. Myhie, Juliette Hascoet, Romain Mathieu, L. Soulat, Karim Bensalah, Sandra Abergel, S. Gauthier, Service des urgences [Rennes] = Emergency [Rennes], CHU Pontchaillou [Rennes], Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service de radiologie et imagerie médicale [Rennes] = Radiology [Rennes], Département de médecine générale (DMG), Université de Rennes 1 - Faculté de Médecine (UR1 Médecine), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), ARN régulateurs bactériens et médecine (BRM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université de Rennes - Faculté de Médecine (UR Médecine), and Université de Rennes (UR)-Université de Rennes (UR)
- Subjects
Adult ,CT scan ,medicine.medical_specialty ,Multivariate analysis ,Adolescent ,[SDV]Life Sciences [q-bio] ,Pain ,Imaging ,03 medical and health sciences ,Young Adult ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Internal medicine ,Ultrasound ,Clinical endpoint ,Medicine ,Imaging diagnosis ,Humans ,Aged ,Pain Measurement ,Retrospective Studies ,Ultrasonography ,Aged, 80 and over ,0303 health sciences ,Pyelonephritis ,030306 microbiology ,business.industry ,Emergency department ,Middle Aged ,3. Good health ,Intensity (physics) ,Infectious Diseases ,Morphine use ,Initial phase ,Acute Disease ,Observational study ,Female ,business ,Tomography, X-Ray Computed - Abstract
Objective To identify predictive factors of urological complication on imaging findings in women with pyelonephritis aged 18 to 65 years. Methods We performed an observational, retrospective, single-center study. The medical charts of women diagnosed with pyelonephritis at the emergency department from 2010 to 2015 were reviewed. Only patients who underwent an imaging study at the emergency department and with microbiologically confirmed pyelonephritis were included for analysis. The primary endpoint was the presence of urological complications on imaging findings. The secondary endpoint was treatment changes after imaging diagnosis. Results Of the 193 women enrolled, 88 (45.6%) had urological complication(s) on imaging findings. The multivariate analysis revealed that history of urolithiasis (OR = 2.41; P = 0.01) and pain requiring morphine use (OR = 5.29; P = 0.009) were predictive of urological complications on imaging findings. Of the 120 women with uncomplicated pyelonephritis who underwent imaging studies, 45% had urological complication, resulting in a treatment change in 36.7% of patients. The multivariate analysis revealed that age > 40 years (OR = 4.58; P = 0.02) and pain requiring morphine use (OR = 3.78; P = 0.02) were predictive of urological complication(s) on imaging findings and of treatment change based on imaging findings (OR = 6.76; P = 0.005 and OR = 4.19; P = 0.01 respectively) in this subgroup. Conclusions Pain requiring morphine use, age, and history of urolithiasis are independent predictors of urological complications on imaging findings in patients with acute pyelonephritis.
- Published
- 2020