Simplified Diagnosis of Urosepsis by Emergency Ultrasound Combined with Clinical Scores and Biomarkers-Reference-Cited by-同舟云学术

Simplified Diagnosis of Urosepsis by Emergency Ultrasound Combined with Clinical Scores and Biomarkers

Published:2024-01-01 Issue:1 Volume:10 Page:30-37
ISSN:2393-1817
Container-title:The Journal of Critical Care Medicine
language:en
Short-container-title:

Author:

Dragoescu Alice Nicoleta¹,Dragoescu Petru Octavian¹,Stanculescu Andreea Doriana²,Padureanu Vlad¹,Dop Dalia¹,Radu Mihai Alexandru¹,Florescu Mirela Marinela¹,Maria Daniela Teodora¹,Florescu Dan Nicolae¹,Mitroi George¹

Affiliation:

1. Faculty of Medicine , University of Medicine and Pharmacy of Craiova , Craiova , Romania

2. Faculty of Pharmacy , University of Medicine and Pharmacy of Craiova , Craiova , Romania

Abstract

Abstract Background Urosepsis is a life-threatening medical condition due to a systemic infection that originates in the urinary tract. Early diagnosis and treatment of urosepsis are critical to reducing mortality rates and preventing complications. Our study was aimed at identifying a fast and reliable method for early urosepsis diagnosis and severity assessment by combining prognostic scores such as SOFA and NEWS with ultrasound examination and serum markers PCT and NLR. Methods We performed a single-center prospective observational study in the Craiova Clinical Emergency Hospital. It initially analysed 204 patients admitted for sepsis of various origins in our hospital between June and October 2023. Those with urological conditions that were suspected to have urosepsis have been selected for the study so that finally 76 patients were included as follows: the severe cases with persistent hypotension requiring vasopressor were enrolled in the septic shock group (15 patients - 19.7%), while the rest were included in the sepsis group (61 patients - 80.3%). Mortality rate in our study was 10.5% (8/76 deaths due to sepsis). Results Both prognostic scores SOFA and NEWS were significantly elevated in the septic shock group, as were the sepsis markers PCT and NLR. We identified a strong significant positive correlation between the NEWS and SOFA scores (r = 0.793) as well as PCT and NLR (r=0.417). Ultrasound emergency evaluation proved to be similar to CT scan in the diagnosis of urosepsis (RR = 0.944, p=0.264). ROC analysis showed similar diagnostic performance for both scores (AUC = 0.874 for SOFA and 0.791 for NEWS), PCT and NLR (AUC = 0.743 and 0.717). Conclusion Our results indicate that an accurate and fast diagnosis of urosepsis and its severity may be accomplished by combining the use of simpler tools like emergency ultrasound, the NEWS score and NLR which provide a similar diagnosis performance as other more complex evaluations.

Publisher

Walter de Gruyter GmbH

Link

https://www.sciendo.com/pdf/10.2478/jccm-2024-0006

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