Syed Furrukh Omair, Rehman Fazal U, Amin Imrana, Ali Syed Ahsan, Rind Bakhtawar J, Ahmed Bilal
Medicine, Aga Khan University Hospital, Karachi, PAK.
Medicine, Patel Hospital, Karachi, PAK.
Cureus. 2020 Oct 18;12(10):e11024. doi: 10.7759/cureus.11024.
Introduction The incidence of acute pyelonephritis (APN) in the diabetic population is comparatively higher and tends to be more complicated, with serious outcomes. Although complicated pyelonephritis (PN) needs hospital admission and intravenous antibiotics, the magnitude of hospital stay due to comorbidities is limited. This study's aim was to assess the impact of diabetes mellitus on length of hospital stay among patients with PN. Methods We did a retrospective data review of 520 randomly selected hospitalized patients of PN from March 2015 to December 2019 from a tertiary care center. Electronic medical records were used for identifying medical conditions through ICD-10 coding. Length of stay (LOS) was categorized as < five days and ≥ five days. Chi-squared tests were used to compare categorical parameters. Logistic regression models were used for multivariate analyses. Results The study included 520 patients with PN; 194 (37.3 %) men and 326 (62.7%) women. Overall, there were 353 (67.8 %) and 167 (32.1 %) patients with LOS < five and ≥ five days respectively. Most of the patients had lower urinary tract symptoms (90%); among them, the majority (92%) were discharged within five days. Likewise, half of the patients had diabetes (51.2); among them, 53% were discharged after five days. Older age (OR:1.7, 95%CI: 1.1 - 2.6), upper urinary tract symptoms (OR:1.6, 95%CI: 1.1 - 2.4), lower urinary tract symptoms (OR:1.9, 95%CI: 1.1 - 3.5), creatinine greater than 1.5 mg/dl (OR:1.6, 95% CI: 1.1 - 2.4) was positively associated with LOS ≥ 5 days after adjusting for other covariates. Diabetes mellitus was not found to be associated with LOS ≥ 5 days (OR: 0.9, 95%CI: 0.8 - 1.5). Conclusion In patients with acute PN, diabetes mellitus is not independently associated with prolonged hospital stay beyond five days.
糖尿病患者中急性肾盂肾炎（APN）的发病率相对较高，且往往更为复杂，后果严重。尽管复杂性肾盂肾炎（PN）需要住院并静脉使用抗生素，但合并症导致的住院时间延长幅度有限。本研究的目的是评估糖尿病对PN患者住院时间的影响。方法：我们对2015年3月至2019年12月从一家三级医疗中心随机选取的520例住院PN患者进行了回顾性数据审查。通过ICD-10编码利用电子病历识别医疗状况。住院时间（LOS）分为<5天和≥5天。采用卡方检验比较分类参数。使用逻辑回归模型进行多变量分析。结果：该研究纳入了520例PN患者；194例（37.3%）为男性，326例（62.7%）为女性。总体而言，分别有353例（67.8%）和167例（32.1%）患者的LOS<5天和≥5天。大多数患者有下尿路症状（90%）；其中，大多数（92%）在5天内出院。同样，一半的患者患有糖尿病（51.2%）；其中，53%在5天后出院。在调整其他协变量后，年龄较大（OR：1.7，95%CI：1.1 - 2.6）、上尿路症状（OR：1.6，95%CI：1.1 - 2.4）、下尿路症状（OR：1.9，95%CI：1.1 - 3.5）、肌酐大于1.5mg/dl（OR：1.6，95%CI：1.1 - 2.4）与LOS≥5天呈正相关。未发现糖尿病与LOS≥5天相关（OR：0.9，95%CI：0.8 - 1.5）。结论：在急性PN患者中，糖尿病并非独立与住院时间延长超过5天相关。
