Observational studyBMC infectious diseases2014
Clinical and epidemiological features and prognosis of complicated pyelonephritis: a prospective observational single hospital-based study.
Observational study in BMC infectious diseases, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 50 citations in OpenAlex.
- Assessing the economic burden of complicated urinary tract infection: A systematic literature review.The European journal of health economics : HEPAC : health economics in prevention and care · 2026Pooled it
- Hospitalization for community-acquired febrile urinary tract infection: validation and impact assessment of a clinical prediction rule.BMC infectious diseases · 2017Trial
- Uropathogens and prognosis among patients with hospital-diagnosed acute pyelonephritis: insights from a 19-year population-based cohort study.Infection · 2026Article
- Patient Characteristics and Clinical Outcomes of Acute Pyelonephritis Treated in Mayo Clinic's Hospital-at-Home Program.Open forum infectious diseases · 2026Article
- Predictors of Renal Replacement Therapy Requirement in Acute Kidney Injury Due to Urinary Sepsis: A Single-Center Retrospective Study.Yonago acta medica · 2025Article
- A Systematic Literature Review of the Epidemiology of Complicated Urinary Tract Infection.Infectious diseases and therapy · 2025Review
- Radiological Explorations of Patients with Upper or Febrile Urinary Tract Infection.Infectious disease reports · 2024Article
- Temporal changes in incidence of hospital-diagnosed acute pyelonephritis: A 19-year population-based Danish cohort study.IJID regions · 2023Article
- Do post-surgical multiresistant urinary infections occur in horses? Case of unilateral pyelonephritis caused by extended-spectrum beta-lactamase-producing bacteria as a complication of cystotomy.Veterinary medicine and science · 2023Article
- Risk Factors for Bacteremia and Its Clinical Impact on Complicated Community-Acquired Urinary Tract Infection.Microorganisms · 2023Article
- Factors Associated with Acute Community-Acquired Pyelonephritis Caused by Extended-Spectrum β-Lactamase-ProducingJournal of clinical medicine · 2021Article
- Hospitalization for urinary tract infections in Japan, 2010-2015: a retrospective study using a national inpatient database.BMC infectious diseases · 2021Observational
- Management of acute pyelonephritis in the emergency department observation unit.Singapore medical journal · 2021Article
- Urosepsis and the urologist!Current urology · 2021Article
- Clinical and computed tomography factors associated with sepsis in women with clinically uncomplicated pyelonephritis.Abdominal radiology (New York) · 2021Article
- Microbiological Features and Clinical Factors Associated with Empirical Antibiotic Resistance in Febrile Patients with Upper Urinary Tract Calculi.Journal of Korean medical science · 2021Article
- Trends in urinary tract infection hospitalization in older adults in Spain from 2000-2015.PloS one · 2021Article
- Risk factors for uroseptic shock in hospitalized patients aged over 80 years with urinary tract infection.Annals of translational medicine · 2020Article
- Management of Febrile Urinary Tract Infection With or Without Bacteraemia in Children: A French Case-Control Retrospective Study.Frontiers in pediatrics · 2020Article
- Clinical impact of perinephric fat stranding detected on computed tomography in patients with acute pyelonephritis: a retrospective observational study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2019Observational
Corrections and comments
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundComplicated pyelonephritis (cPN), a common cause of hospital admission, is still a poorly-understood entity given the difficulty involved in its correct definition. The aim of this study was to analyze the main epidemiological, clinical, and microbiological characteristics of cPN and its prognosis in a large cohort of patients with cPN.
methodsWe conducted a prospective, observational study including 1325 consecutive patients older than 14 years diagnosed with cPN and admitted to a tertiary university hospital between 1997-2013. After analyzing the main demographic, clinical and microbiological data, covariates found to be associated with attributable mortality in univariate analysis were included in a multivariate logistic regression model.
resultsOf the 1325 patients, 689 (52%) were men and 636 (48%) women; median age 63 years, interquartile range [IQR] (46.5-73). Nine hundred and forty patients (70.9%) had functional or structural abnormalities in the urinary tract, 215 (16.2%) were immunocompromised, 152 (11.5%) had undergone a previous urinary tract instrumentation, and 196 (14.8%) had a long-term bladder catheter, nephrostomy tube or ureteral catheter. Urine culture was positive in 813 (67.7%) of the 1251 patients in whom it was done, and in the 1032 patients who had a blood culture, 366 (34%) had bacteraemia. Escherichia coli was the causative agent in 615 episodes (67%), Klebsiella spp in 73 (7.9%) and Proteus ssp in 61 (6.6%). Fourteen point one percent of GNB isolates were ESBL producers. In total, 343 patients (25.9%) developed severe sepsis and 165 (12.5%) septic shock. Crude mortality was 6.5% and attributable mortality was 4.1%. Multivariate analysis showed that an age >75 years (OR 2.77; 95% CI, 1.35-5.68), immunosuppression (OR 3.14; 95% CI, 1.47-6.70), and septic shock (OR 58.49; 95% CI, 26.6-128.5) were independently associated with attributable mortality.
conclusionscPN generates a high morbidity and mortality and likely a great consumption of healthcare resources. This study highlights the factors directly associated with mortality, though further studies are needed in the near future aimed at identifying subgroups of low-risk patients susceptible to outpatient management.
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