PREDICTIVE POTENTIAL OF SOFA SCORE IN EFFECTIVE CONSERVATIVE MANAGEMENT OF EMPHYSEMATOUS PYELONEPHRITIS
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Abstract
Background: Urinary tract infections (UTIs) acquired in the community or hospital are a common cause of urosepsis, which develops in 20% to 30% of sepsis patients. The SOFA score evaluates and rates the dysfunction of six different organ systems, including the respiratory system (including partial arterial oxygen pressure, fraction of inspired oxygen, and respiratory support), coagulation, platelet count, liver, cardiovascular, neurological, and renal systems (including creatinine and urine output).
Methadology: A prospective analysis including 55 patients admitted with a diagnosis of emphysematous pyelonephritis based on a CT scan was carried out in Shaikh Zayed Hospital, Lahore, from 2021 to 2022. Clinical information was acquired on patients who had a history of upper urinary tract blockage based on a CT scan and who were treated conservatively. Patients who had no prior history of organ failure at the time of presentation were given a SOFA score of 0, and the SOFA score is then assessed for all patients who were treated primarily with medications, ureteric stenting, and percutaneous drainage.
Results: Upper ureteric tract blockage (0.0204) and conservative management techniques such medications, ureteric stents, or PCD (0.001) are strongly related to changes in SOFA scores in patients with emphysematous pyelonephritis.
Conclusion: A decline in SOFA score corresponds to obstruction of the upper ureteric tract.In emphysematous pyelonephritis, percutaneous catheter drainage is far more effective than retrograde ureteric stenting at preventing the deterioration of the SOFA score.
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Muhammad Tayyab Naeem
Department of Urology, Sheikh Zayed Hospital, Lahore - Pakistan
Abdul Rauf
Department of Urology, Sheikh Zayed Hospital, Lahore - Pakistan
Fazal Ur Rehman
Department of Urology, Sheikh Zayed Hospital, Lahore - Pakistan
Abdul Razaq
Muhammad Islam Teaching Hospital, Gujranwala - Pakistan
Muhammad Yahya Hassan
Department of Urology, Sheikh Zayed Hospital, Lahore - Pakistan
Ahmed Hassan Usman
University Hospitals of Birmingham - UK