<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec><h3>Background</h3>
<p>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.</p>
</sec>
<sec><h3>Methods</h3>
<p>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).</p>
</sec>
<sec><h3>Results</h3>
<p>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).</p>
</sec>
<sec><h3>Conclusion</h3>
<p>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.</p>
</sec>
</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.

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

University of Medicine and Pharmacy of Craiova

The Journal of Critical Care Medicine

This work is licensed under the Creative Commons Attribution 4.0 International License.

Background
Urosepsis is a life-threatening medical condition due to a systemic infection that originates in the urinary tract. Early diagnosis and treatment of...

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

Article Category: Research Article

Publicado en línea: 30 ene 2024

Páginas: 30 - 37

Recibido: 04 nov 2023

Aceptado: 10 dic 2023

DOI: https://doi.org/10.2478/jccm-2024-0006

Palabras clave
urosepsis, ultrasound, neutrophil-to-lymphocyte ratio, procalcitonin, NEWS, SOFA

© 2024 Alice Nicoleta Dragoescu et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

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

Article Category: Research Article

Publicado en línea: 30 ene 2024

Páginas: 30 - 37

Recibido: 04 nov 2023

Aceptado: 10 dic 2023

DOI: https://doi.org/10.2478/jccm-2024-0006

Palabras claveurosepsis, ultrasound, neutrophil-to-lymphocyte ratio, procalcitonin, NEWS, SOFA

© 2024 Alice Nicoleta Dragoescu et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Palabras clave
urosepsis, ultrasound, neutrophil-to-lymphocyte ratio, procalcitonin, NEWS, SOFA