What Are the Predictive Factors of Severe Conditions in Acute Obstructive Pyelonephritis?

Acute obstructive pyelonephritis is a common urological infection, often requiring emergency drainage, which shows rapid progression to serious conditions, including severe sepsis or septic shock. Therefore, during an initial evaluation, knowledge of factors for prediction of severe conditions or mortality is important for immediate identification of patients requiring intensive care. Previous studies examining the characteristics of patients with acute obstructive or calculous pyelonephritis reported rates of septic shock and mortality of 20.8-33.3% and 0-7.4%, respectively. Thrombocytopenia, older age, low serum albumin, and bacteremia were relatively common predictors for septic shock. In contrast, age over 80 years, systemic inflammatory response syndrome, disseminated intravascular coagulation status, disturbance of consciousness, male gender, and having only one kidney were predictive factors for mortality.