Table of Contents Author Guidelines Submit a Manuscript
BioMed Research International
Volume 2015, Article ID 717094, 7 pages
http://dx.doi.org/10.1155/2015/717094
Research Article

Risk Factors for Development of Septic Shock in Patients with Urinary Tract Infection

1Department of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
2Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
3Department of Nephrology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan
4Department of Emergency, FooYin University Hospital, Pingtung County, Taiwan
5Department of Nurse, Tajen University, Pingtung, Taiwan
6Division of Allergy, Asthma, and Rheumatology, Departmen of Pediatrics, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan
7Department of Genetics, University of Alabama at Birmingham, Birmingham, AL, USA
8Department of Applied Life Science and Health, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
9Department of Family Medicine, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan
10Division of Chest, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
11School of Medicine, Chung Shan Medical University, Taichung, Taiwan

Received 21 April 2015; Revised 10 July 2015; Accepted 13 July 2015

Academic Editor: Florian M. Wagenlehner

Copyright © 2015 Chih-Yen Hsiao et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Severe sepsis and septic shock are associated with substantial mortality. However, few studies have assessed the risk of septic shock among patients who suffered from urinary tract infection (UTI). Materials and Methods. This retrospective study recruited UTI cases from an acute care hospital between January 2006 and October 2012 with prospective data collection. Results. Of the 710 participants admitted for UTI, 80 patients (11.3%) had septic shock. The rate of bacteremia is 27.9%; acute kidney injury is 12.7%, and the mortality rate is 0.28%. Multivariable logistic regression analyses indicated that coronary artery disease (CAD) (OR: 2.521, 95% CI: 1.129–5.628, ), congestive heart failure (CHF) (OR: 4.638, 95% CI: 1.908–11.273, ), and acute kidney injury (AKI) (OR: 2.992, 95% CI: 1.610–5.561, ) were independently associated with septic shock in patients admitted with UTI. In addition, congestive heart failure (female, OR: 4.076, 95% CI: 1.355–12.262, ; male, OR: 5.676, 95% CI: 1.103–29.220, , resp.) and AKI (female, OR: 2.995, 95% CI: 1.355–6.621, ; male, OR: 3.359, 95% CI: 1.158–9.747, , resp.) were significantly associated with risk of septic shock in both gender groups. Conclusion. This study showed that patients with a medical history of CAD or CHF have a higher risk of shock when admitted for UTI treatment. AKI, a complication of UTI, was also associated with septic shock. Therefore, prompt and aggressive management is recommended for those with higher risks to prevent subsequent treatment failure in UTI patients.