Predictive Value Of Neutrophil-To-Lymphocyte Ratio For Unfavorable Outcomes In Emphysematous Pyelonephritis: A Clinical Risk Stratification Study
DOI:
https://doi.org/10.36283/ziun-pjmd15-2/008Keywords:
Emphysematous pyelonephritis (EPN), neutrophil: lymphocyte ratio (NLR)Abstract
Background: Emphysematous pyelonephritis (EPN) is a life-threatening necrotizing infection of the renal parenchyma, marked by gas formation within the renal structures. It is strongly associated with diabetes mellitus. While nephrectomy was historically the mainstay of treatment, recent studies suggest that conservative management using stenting, percutaneous drainage, or medical therapy may be effective. The aim was to determine the frequency of unfavourable outcomes after primary procedures in patients presenting with EPN and compare the frequency of unfavourable outcomes among patients with NLR <5 and >5.
Methods: This descriptive study was conducted at the Department of Urology, Sindh Institute of Urology and Transplantation, Karachi, from 18-06-2020 to 17-12-2020. A total of 66 patients aged 30–70 years with CT-confirmed EPN were included. Patients were grouped by neutrophil-to-lymphocyte ratio (NLR) at admission. Disease severity was assessed using Huang-Tseng classification. All patients were followed for one-month post-intervention to assess outcomes.
Results: Mean age was 50.38±11.09 years, and mean disease duration was 3.15±1.47 months. Females were 74.24% of the cohort, and 72.73% were diabetic. NLR >5 was found in 51.52% of cases. Unfavourable outcomes occurred in 24.24%, significantly more in those with NLR >5.
Conclusion: NLR is a useful prognostic marker to predict unfavourable outcomes in EPN managed conservatively.
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