Re: Temporal trends, practice patterns, and treatment outcomes for infected upper urinary tract stones in the United States

摘要

This study of a large inpatient database demonstrated that more patients are suffering from stones associated with infection. The higher proportion of women is expected, as they are more prone to urinary tract infection. The increased incidence of septic complications is anticipated, given the aforementioned trends. The lack of increase in mortality is reflective of the better critical care services delivered to patients. The low percentage of patients undergoing immediate decompression is disturbing. This finding may be due to initial care being provided by nonurologists, who may not be attuned to the emergent need for decompression. If so, these physicians clearly need to be educated about the importance of drainage of obstructed and infected renal units. The higher mortality rate in those undergoing percutaneous nephrostomy drainage may be due to selection bias, as this group could have been more severely compromised.