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Pyelonephritis - acute - Evidence
Evidence on risk factors for developing a complication of acute pyelonephritis

Risk factors for the development of a serious complication of acute pyelonephritis have been identified in an observational study using multi-variant analysis [Efstathiou et al, 2003]. This study, however, did not quantify the level of risk from each factor. An individual's risk will vary according to their overall state of health and age. Clinical judgement must be used to estimate the risk for each person.

  • The study included 225 people diagnosed with acute pyelonephritis. Data were collected on:
    • Thirteen variables that were thought to be risk factors for the development of a serious complication of acute pyelonephritis.
    • Serious complications included death, treatment failure, and prolonged duration of stay in hospital.
  • The increased risk of a serious complication was calculated for each variable using multi-variant analysis.
  • Results:
    • Increased risk of death from acute pyelonephritis was associated with:
      • People older than 65 years of age.
      • Bedridden status.
      • Septic shock.
      • Recurrent acute pyelonephritis.
      • Diabetes.
      • Renal calculi.
      • Immunosuppression.
    • Prolonged hospitalization was associated with:
      • Diabetes.
      • Long-term catheterization.
      • People older than 65 years of age.
    • Treatment failure was associated with:
      • Recent hospitalization.
      • Recent use of antibiotics.

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