Studies conducted at I. Berger et al on nephrectomy recently published
2009 AUG 4 - (NewsRx.com) -- A report, 'Emergency nephrectomy due to severe urosepsis: a retrospective, multicentre analysis of 65 cases,' is newly published data in Bju International. "To assess the outcome of emergency nephrectomy in a retrospective, multicentre analysis, as emergency nephrectomy due to life-threatening urosepsis is a rare clinical scenario with a high mortality, and there are few reports of clinical data on this issue. We assessed retrospectively all patients who had a nephrectomy due to life-threatening urosepsis in three referral centres in Vienna between 1994 and 2007," scientists writing in the journal Bju International report. "Patient characteristics, survival and risk factors for a fatal outcome were evaluated. In all 65 patients (44 women and 21 men; mean age 65 years) were analysed. The mean interval from the first medical consultation to hospital admission was 4.3 days. Two-thirds of patients were admitted directly from their homes (63%), the remainder being transferred from other departments or hospitals. The most common pathological mechanism leading to urosepsis was acute pyelonephritis, often combined with nephrolithiasis. In all, 36 patients had a urological intervention before nephrectomy, i.e. percutaneous nephrostomy in 17, ureteric stent in 16 and percutaneous abscess drainage in three. Nephrectomy was performed a mean (range) of 5.7 (0-31) days after hospital admission. Thirteen patients (20%) died from septic multi-organ failure after surgery. This group was almost 20 years older than those who survived (78.6 vs 61.8 years), had a higher comorbidity rate, had undergone endourological interventions more frequently (69% vs 52%), had a longer interval to nephrectomy (6.9 vs 5.4 days), higher C-reactive protein level (294.9 vs 136.0 mg/L) and lower platelet counts (229.5 vs 307.7 million/L) at diagnosis. Several factors were identified that influence the outcome after emergency nephrectomy for life-threatening urosepsis," wrote I. Berger and colleagues, . The researchers concluded: "Applied to the decision-making process, these risk factors could have a positive impact on establishing a timely indication for nephrectomy that might ultimately reduce the high mortality rate." Berger and colleagues published their study in Bju International (Emergency nephrectomy due to severe urosepsis: a retrospective, multicentre analysis of 65 cases. Bju International, 2009;104(3):386-90). Additional information can be obtained by contacting I. Berger, Donauspital, Dept. of Urology and Andrology, Vienna, Austria. The publisher of the journal Bju International can be contacted at: Blackwell Publishing Inc., 350 Main St., Malden, MA 02148, USA. Keywords: Austria, Vienna, Acute Pyelonephritis, Kidney Calculi, Nephrectomy, Nephrolithiasis, Surgery, Urology. This article was prepared by Disease Prevention Week editors from staff and other reports. Copyright 2009, Disease Prevention Week via NewsRx.com.
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