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  • Temple EM

A risk stratification model of acute pyelonephritis to indicate hospital admission from the ED

The Article: A risk stratification model of acute pyelonephritis to indicate hospital admission from the ED. Kang et al. Am Journ Em Med. 2013 Mar 27.

The Idea: To derive a clinical prediction rule that can accurately predict which patients with acute pyelonephritis require hospital admission.

The Study: A retrospective review of 192 cases of acute pyelonephritis, analyzed for demographic, clinical, and laboratory findings which then underwent regression analysis, internal and external validation to derive a clinical decision rule that predicted need for admission.

The Findings:

A clinical prediction rule and accompanying score, based on age, chill, segmented neutrophils, serum creatinine, CRP, and serum albumin was derived and validated.

The takeaway:

Although the derived rule may accurately predict those patients with acute pyelonephritis who require hospital admission, it does not predict the clinical course, morbidity, or mortality of those patients, and consists of several variables not commonly investigated in the ED workup of acute pyelonephritis.