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J Korean Soc Emerg Med > Volume 27(4); 2016 > Article
Journal of The Korean Society of Emergency Medicine 2016;27(4): 320-327.
일측성 신우신염과 양측성 신우신염의 임상양상과 예후에 대한 비교
김현우, 유승목, 안신, 손창환, 서동우, 이윤선, 이재호, 오범진, 임경수, 김원영
울산대학교 의과대학 서울아산병원 응급의학과
Comparison of Clinical Feature and Prognosis between Unilateral and Bilateral Acute Pyelonephritis
Hyun Woo Kim, Seung Mok Ryoo, Shin Ahn, Chang Hwan Sohn, Dong Woo Seo, Yoon Seon Lee, Jae Ho Lee, Bum Jin Oh, Kyung Soo Lim, Won Young Kim
Department of Emergency Medicine, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
Correspondence  Won Young Kim ,Tel: 02-3010-3350, Fax: 02-3010-3360, Email: wonpia73@naver.com,
Received: March 22, 2016; Revised: March 22, 2016   Accepted: May 27, 2016.  Published online: August 31, 2016.
Acute pyelonephritis (APN) usually presents as a mild disease. However, it has been shown to cause substantial morbidity and mortality on occasion. Therefore, it is important to distinguish between the complicated and uncomplicated APN. The purpose of this study was to determine the clinical significance of bilateral APN compared with unilateral APN in the emergency department (ED).
We analyzed the data of 303 consecutive patients with APN who underwent a abdominal computed tomography (CT) examination in the ED from January 2012 to December 2014. We compared the clinical presentation, progress, and outcomes between the unilateral and bilateral APNs that were identified on the CT scan.
Of these 303 patients, 110 patients (36.3%) were confirmed as bilateral APN by the CT. The proportion of male was higher in the bilateral APN group (20.0% vs. 10.9%, p=0.029). Moreover, patients in the bilateral group visited the ED post symptom onset (6.5±7.8 vs. 3.6±3.1, p<0.001). However, symptom, sign, laboratory test, and CT findings were not statistically different between the two groups. In addition, severity, resistant pathogen, and outcomes such as occurrence of septic shock, hospital days, and mortality were also not different.
This study suggests that bilateral APN, as determined by a CT, does not have clinical significance compared with unilateral APN.
Key words: Emergency service, Hospital, Pyelonephritis, Tomography, X-Ray computed
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