Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
Correspondence
Corresponding author. Department of Emergency Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam 463-707, Korea. Tel.: +82 31 787 7572; fax: +82 31 787 4055.
Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
Correspondence
Corresponding author. Department of Emergency Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam 463-707, Korea. Tel.: +82 31 787 7572; fax: +82 31 787 4055.
To view the full text, please login as a subscribed user or purchase a subscription.
Click here to view the full text on ScienceDirect.
Figures
Fig. 1
Area under the ROC curves of the risk stratification model for predicting admission in the derivation (A), internal validation (B), and external validation (C) cohorts.
Fig. 2
Admission rates of patients in each risk group and cohort.
Abstract
Objectives
There are no guidelines regarding the hospitalization of female patients with acute pyelonephritis (APN); therefore, we performed a retrospective analysis to construct a clinical prediction model for hospital admission.
Methods
We conducted a retrospective analysis of a prospective database of women diagnosed as having APN in the emergency department between January 2006 and June 2012. Independent risk factors for admission were determined by multivariable logistic regression analysis in half of the patients in this database. The risk of admission was categorized into 5 groups. The internal and external validations were conducted using the remaining half of the patients and 192 independent patients, respectively.
Results
Independent risk factors for admission were age of 65 years or greater (odds ratio [OR], 2.62; 1 point), chill (OR, 2.40; 1 point), and the levels of segmented neutrophils greater than 90% (OR, 2.00; 1 point), serum creatinine greater than 1.5 mg/dL (OR, 2.41; 1 point), C-reactive protein greater than 10 mg/dL (OR, 2.37; 1 point), and serum albumin less than 3.3 g/dL (OR, 7.36; 2 points). The admission risk scores consisted of 5 categories, which were very low (0 points; 5.9%), low (1 point; 10.7%), intermediate (2 points; 20.7%), high (3-4 points; 51.9%), and very high (5-7 points; 82.8%) risk, showing an area under the curve of 0.770. The areas under the curve of the internal and external validation cohorts were 0.743 and 0.725, respectively.
Conclusion
This model can provide a guideline to determine the admission of women with APN in the emergency department.
To access this article, please choose from the options below
Article Info