Kakinoki et al reported risk factors for uroseptic shock in a patient with urolithiasis-related acute pyelonephritis. This can help to identify a patient who may require more aggressive management. The authors are from Saga University in Japan.
Patient selection: acute pyelonephritis secondary to urolithiasis, with urinary obstruction
Outcome: urosepsis with shock
Predictor for uroseptic shock on multivariate analysis:
(1) hypoalbuminemia (serum albumin < 3.0 g/dL)
Other predictors for septic shock:
(1) high C-reactive protein (>= 15 mg/dL)
(2) cirrhosis (from Lee et al)
Management requires emergency drainage to decompress the obstructed urine drainage.
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