Prevalence and Risk Factors of Mortality in Emphysematous Pyelonephritis Patients : A Meta-Analysis
© 2022. The Author(s) under exclusive licence to Société Internationale de Chirurgie..
BACKGROUND: Emphysematous pyelonephritis (EP) is a severe necrotizing infection of the renal parenchyma which is associated with significant case mortality. We sought to identify the incidence and predictive risk factors associated with EP mortality.
METHODS: Two electronic databases, PubMed and Web of Science, were searched from their inception until June 06, 2021 for relevant articles. Two independent teams reviewed abstracts and extracted data from the selected manuscripts. A meta-analysis has been reported in line with PRISMA 2020 and AMSTAR Guidelines.
RESULTS: Of the 1080 retrieved abstracts, 79 underwent full-text review and 45 studies were included in the final analysis, comprising a total cohort of 1303 patients and 177 mortalities. The pooled prevalence of mortality among the patients with EP disease was 13%. Our analysis found a significantly decreasing trend in mortality rates, an increasing trend in minimally invasive intervention and decreasing trends in emergency nephrectomy in the EP studies from 1985 to 2020. Significant risk factors that were associated with a negative impact on survival of EP patients included sepsis (OR = 15.99), shock (OR = 15.57), disturbance of consciousness (OR = 12.11), thrombocytopenia (OR 7.85), acute renal failure (OR = 5.41), Wan classification I (OR = 4.57), emergency nephrectomy (OR = 3.73), Huang-Tseng classification III-IV (OR = 2.4) and medical management alone (OR = 2.04). Female sex (OR = 0.52) and minimally invasive intervention (OR = 0.47) (percutaneous nephrostomy or ureteral stent placement) were associated with decreased mortality rates.
CONCLUSIONS: Our study results demonstrated several significant risk factors that could help guide treatment to reduce the mortality risk of EP patients. Clinically, early treatment with a combination of minimally invasive intervention and appropriate medical management may be protective for reducing mortality risk in EP patients.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:46 |
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| Enthalten in: |
World journal of surgery - 46(2022), 10 vom: 08. Okt., Seite 2377-2388 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ngo, Xuan Thai [VerfasserIn] |
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| Anmerkungen: |
Date Completed 08.09.2022 Date Revised 26.10.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00268-022-06647-1 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM343226901 |
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| 100 | 1 | |a Ngo, Xuan Thai |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Prevalence and Risk Factors of Mortality in Emphysematous Pyelonephritis Patients |b A Meta-Analysis |
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| 520 | |a © 2022. The Author(s) under exclusive licence to Société Internationale de Chirurgie. | ||
| 520 | |a BACKGROUND: Emphysematous pyelonephritis (EP) is a severe necrotizing infection of the renal parenchyma which is associated with significant case mortality. We sought to identify the incidence and predictive risk factors associated with EP mortality | ||
| 520 | |a METHODS: Two electronic databases, PubMed and Web of Science, were searched from their inception until June 06, 2021 for relevant articles. Two independent teams reviewed abstracts and extracted data from the selected manuscripts. A meta-analysis has been reported in line with PRISMA 2020 and AMSTAR Guidelines | ||
| 520 | |a RESULTS: Of the 1080 retrieved abstracts, 79 underwent full-text review and 45 studies were included in the final analysis, comprising a total cohort of 1303 patients and 177 mortalities. The pooled prevalence of mortality among the patients with EP disease was 13%. Our analysis found a significantly decreasing trend in mortality rates, an increasing trend in minimally invasive intervention and decreasing trends in emergency nephrectomy in the EP studies from 1985 to 2020. Significant risk factors that were associated with a negative impact on survival of EP patients included sepsis (OR = 15.99), shock (OR = 15.57), disturbance of consciousness (OR = 12.11), thrombocytopenia (OR 7.85), acute renal failure (OR = 5.41), Wan classification I (OR = 4.57), emergency nephrectomy (OR = 3.73), Huang-Tseng classification III-IV (OR = 2.4) and medical management alone (OR = 2.04). Female sex (OR = 0.52) and minimally invasive intervention (OR = 0.47) (percutaneous nephrostomy or ureteral stent placement) were associated with decreased mortality rates | ||
| 520 | |a CONCLUSIONS: Our study results demonstrated several significant risk factors that could help guide treatment to reduce the mortality risk of EP patients. Clinically, early treatment with a combination of minimally invasive intervention and appropriate medical management may be protective for reducing mortality risk in EP patients | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Review | |
| 700 | 1 | |a Nguyen, Tuan Thanh |e verfasserin |4 aut | |
| 700 | 1 | |a Dobbs, Ryan W |e verfasserin |4 aut | |
| 700 | 1 | |a Thai, Minh Sam |e verfasserin |4 aut | |
| 700 | 1 | |a Vu, Duc Huy |e verfasserin |4 aut | |
| 700 | 1 | |a Dinh, Le Quy Van |e verfasserin |4 aut | |
| 700 | 1 | |a Quy, Khoa |e verfasserin |4 aut | |
| 700 | 1 | |a Le, Hieu Trong |e verfasserin |4 aut | |
| 700 | 1 | |a Hoang, Tien-Dat |e verfasserin |4 aut | |
| 700 | 1 | |a Ngo, Hanh Thi Tuyet |e verfasserin |4 aut | |
| 700 | 1 | |a Van, Trinh Ngoc Khanh |e verfasserin |4 aut | |
| 700 | 1 | |a Tiong, Ho Yee |e verfasserin |4 aut | |
| 700 | 1 | |a Vuong, Huy Gia |e verfasserin |4 aut | |
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