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Catheter Management and Risk Stratification of Patients With in Inpatient Treatment Due to Acute Epididymitis

Objective: This study aims to evaluate catheter management in acute epididymitis (AE) patients requiring inpatient treatment and risk factors predicting severity of disease. Material and Methods: Patients with diagnosed AE and inpatient treatment between 2004 and 2019 at the University Hospital Fran...

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Autores principales: Wenzel, Mike, Deuker, Marina, Welte, Maria N., Hoeh, Benedikt, Preisser, Felix, Homrich, Till, Kempf, Volkhard A. J., Hogardt, Michael, Mandel, Philipp, Karakiewicz, Pierre I., Chun, Felix K. H., Kluth, Luis A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7744346/
https://www.ncbi.nlm.nih.gov/pubmed/33344499
http://dx.doi.org/10.3389/fsurg.2020.609661
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author Wenzel, Mike
Deuker, Marina
Welte, Maria N.
Hoeh, Benedikt
Preisser, Felix
Homrich, Till
Kempf, Volkhard A. J.
Hogardt, Michael
Mandel, Philipp
Karakiewicz, Pierre I.
Chun, Felix K. H.
Kluth, Luis A.
author_facet Wenzel, Mike
Deuker, Marina
Welte, Maria N.
Hoeh, Benedikt
Preisser, Felix
Homrich, Till
Kempf, Volkhard A. J.
Hogardt, Michael
Mandel, Philipp
Karakiewicz, Pierre I.
Chun, Felix K. H.
Kluth, Luis A.
author_sort Wenzel, Mike
collection PubMed
description Objective: This study aims to evaluate catheter management in acute epididymitis (AE) patients requiring inpatient treatment and risk factors predicting severity of disease. Material and Methods: Patients with diagnosed AE and inpatient treatment between 2004 and 2019 at the University Hospital Frankfurt were analyzed. A risk score, rating severity of AE, including residual urine > 100 ml, fever > 38.0°C, C-reactive protein (CRP) > 5 mg/dl, and white blood count (WBC) > 10/nl was introduced. Results: Of 334 patients, 107 (32%) received a catheter (transurethral (TC): n = 53, 16%, suprapubic (SPC): n = 54, 16%). Catheter patients were older, exhibited more comorbidities, and had higher CRP and WBC compared with the non-catheter group (NC). Median length of stay (LOS) was longer in the catheter group (7 vs. 6 days, p < 0.001), whereas necessity of abscess surgery and recurrent epididymitis did not differ. No differences in those parameters were recorded between TC and SPC. According to our established risk score, 147 (44%) patients exhibited 0–1 (low-risk) and 187 (56%) 2–4 risk factors (high-risk). In the high-risk group, patients received a catheter significantly more often than with low-risk (TC: 22 vs. 9%; SPC: 19 vs. 12%, both p ≤ 0.01). Catheter or high-risk patients exhibited positive urine cultures more frequently than NC or low-risk patients. LOS was comparable between high-risk patients with catheter and low-risk NC patients. Conclusion: Patients with AE who received a catheter at admission were older, multimorbid, and exhibited more severe symptoms of disease compared with the NC patients. A protective effect of catheters might be attributable to patients with adverse risk constellations or high burden of comorbidities. The introduced risk score indicates a possibility for risk stratification.
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spelling pubmed-77443462020-12-18 Catheter Management and Risk Stratification of Patients With in Inpatient Treatment Due to Acute Epididymitis Wenzel, Mike Deuker, Marina Welte, Maria N. Hoeh, Benedikt Preisser, Felix Homrich, Till Kempf, Volkhard A. J. Hogardt, Michael Mandel, Philipp Karakiewicz, Pierre I. Chun, Felix K. H. Kluth, Luis A. Front Surg Surgery Objective: This study aims to evaluate catheter management in acute epididymitis (AE) patients requiring inpatient treatment and risk factors predicting severity of disease. Material and Methods: Patients with diagnosed AE and inpatient treatment between 2004 and 2019 at the University Hospital Frankfurt were analyzed. A risk score, rating severity of AE, including residual urine > 100 ml, fever > 38.0°C, C-reactive protein (CRP) > 5 mg/dl, and white blood count (WBC) > 10/nl was introduced. Results: Of 334 patients, 107 (32%) received a catheter (transurethral (TC): n = 53, 16%, suprapubic (SPC): n = 54, 16%). Catheter patients were older, exhibited more comorbidities, and had higher CRP and WBC compared with the non-catheter group (NC). Median length of stay (LOS) was longer in the catheter group (7 vs. 6 days, p < 0.001), whereas necessity of abscess surgery and recurrent epididymitis did not differ. No differences in those parameters were recorded between TC and SPC. According to our established risk score, 147 (44%) patients exhibited 0–1 (low-risk) and 187 (56%) 2–4 risk factors (high-risk). In the high-risk group, patients received a catheter significantly more often than with low-risk (TC: 22 vs. 9%; SPC: 19 vs. 12%, both p ≤ 0.01). Catheter or high-risk patients exhibited positive urine cultures more frequently than NC or low-risk patients. LOS was comparable between high-risk patients with catheter and low-risk NC patients. Conclusion: Patients with AE who received a catheter at admission were older, multimorbid, and exhibited more severe symptoms of disease compared with the NC patients. A protective effect of catheters might be attributable to patients with adverse risk constellations or high burden of comorbidities. The introduced risk score indicates a possibility for risk stratification. Frontiers Media S.A. 2020-12-03 /pmc/articles/PMC7744346/ /pubmed/33344499 http://dx.doi.org/10.3389/fsurg.2020.609661 Text en Copyright © 2020 Wenzel, Deuker, Welte, Hoeh, Preisser, Homrich, Kempf, Hogardt, Mandel, Karakiewicz, Chun and Kluth. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Surgery
Wenzel, Mike
Deuker, Marina
Welte, Maria N.
Hoeh, Benedikt
Preisser, Felix
Homrich, Till
Kempf, Volkhard A. J.
Hogardt, Michael
Mandel, Philipp
Karakiewicz, Pierre I.
Chun, Felix K. H.
Kluth, Luis A.
Catheter Management and Risk Stratification of Patients With in Inpatient Treatment Due to Acute Epididymitis
title Catheter Management and Risk Stratification of Patients With in Inpatient Treatment Due to Acute Epididymitis
title_full Catheter Management and Risk Stratification of Patients With in Inpatient Treatment Due to Acute Epididymitis
title_fullStr Catheter Management and Risk Stratification of Patients With in Inpatient Treatment Due to Acute Epididymitis
title_full_unstemmed Catheter Management and Risk Stratification of Patients With in Inpatient Treatment Due to Acute Epididymitis
title_short Catheter Management and Risk Stratification of Patients With in Inpatient Treatment Due to Acute Epididymitis
title_sort catheter management and risk stratification of patients with in inpatient treatment due to acute epididymitis
topic Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7744346/
https://www.ncbi.nlm.nih.gov/pubmed/33344499
http://dx.doi.org/10.3389/fsurg.2020.609661
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