Please use this identifier to cite or link to this item:
Title: Management of acute pyelonephritis in the emergency department observation unit.
Authors: Khoo, Kathleen Swee Min
Lim, Zhen Yu
Chai, Chew Yian 
Mahadevan, Malcolm 
Kuan, Win Sen 
Keywords: emergency service
observation unit
Issue Date: 9-Mar-2020
Publisher: Singapore Medical Journal
Citation: Khoo, Kathleen Swee Min, Lim, Zhen Yu, Chai, Chew Yian, Mahadevan, Malcolm, Kuan, Win Sen (2020-03-09). Management of acute pyelonephritis in the emergency department observation unit.. Singapore Med J. ScholarBank@NUS Repository.
Abstract: INTRODUCTION: This study aimed to assess the effectiveness of the emergency department observation unit (EDOU) for patients with acute pyelonephritis in a Singapore tertiary academic medical centre. METHODS: We reviewed the clinical records of consecutive patients who presented with pyelonephritis between 1 July 2012 and 31 October 2014 to collect information on demographics, symptoms, signs, laboratory and radiological results, treatment, and clinical outcomes. RESULTS: Of 459 emergency department (ED) patients who were identified as having pyelonephritis, 164 (35.7%) were managed in the EDOU. Successful management in the EDOU was achieved in 100 (61.0%) patients. Escherichia coli was the predominant (64.6%) micro-organism in urine cultures and was positive in 106 patients. Patients diagnosed with acute pyelonephritis who were successfully managed in the EDOU had a lower incidence of nausea (32.0% vs. 60.9%, p < 0.001) and vomiting (15.0% vs. 50.0%, p < 0.001) compared to those who were not successful. CONCLUSION: EDOU is useful for both observation and treatment of patients with acute pyelonephritis. Urine cultures are sufficient for the identification of the culprit micro-organism. Patients who present with prominent symptoms of vomiting should have routine administration of antiemetics, while consideration for second-line antiemetics is recommended for those with persistent symptoms.
Source Title: Singapore Med J
ISSN: 00375675
DOI: 10.11622/smedj.2020020
Appears in Collections:Staff Publications

Show full item record
Files in This Item:
File Description SizeFormatAccess SettingsVersion 
OA-2018-286-epub.pdfPublished version548.54 kBAdobe PDF




checked on Sep 22, 2021

Page view(s)

checked on Jan 20, 2022


checked on Jan 20, 2022

Google ScholarTM



Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.