scholarly journals Polymicrobial and monomicrobial necrotizing fasciitis: clinical, laboratory, radiology, pathological hallmark and differences, a retrospective analysis

2021 ◽  
Author(s):  
Eviatar Naaman ◽  
Shachaf Shiber ◽  
Daskin-Bitan Hadar ◽  
Dafna Yahav ◽  
Jihad Bishara ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Necrotizing Fasciitis ◽  
Clinical Laboratory ◽  
Medical Center ◽  
High Morbidity ◽  
Icu Admission ◽  
Duration Of Hospitalization ◽  
Life Threatening ◽  
Microbial Groups ◽  
Vasopressor Use

Abstract Background: Necrotizing fasciitis (NF) is a life-threatening infection with high morbidity and mortality rates which should be diagnosed and treated with surgical and antibiotic therapy. Many studies have addressed NF and its subtypes, but few have reviewed the clinical, radiological and pathological differences between the poly-microbial and the mono-microbial groups. Objective: The objective of our study is to describe a relatively large cohort of patients with NF and study and compare the clinical, radiological and pathological differences between the poly-microbial (Pm) and the mono-microbial (Mm) groups.Methods: The charts of hospitalized patients with NF diagnosis from 2002-2019 at the Rabin Medical Center were reviewed. The primary outcome was all-cause mortality at 90 days, secondary outcomes included duration of hospitalization, intensive care unit (ICU) admission, LRINEC score and the need for vasopressor use. Results: 81 patients with NF were included in the study, 54(66.6%) had Mm growth and 27(33.3%) had Pm growth. There were no significant differences between the two groups in the 90 days mortality, and moreover in hospital mortality was also insignificantly different. In a multivariate analysis, we found that 90 days mortality was more prevalent in the Mm group compared to Pm group. In addition, we found that in hospital mortality, ICU admission and vasopressors use were more frequent among the Mm-group compared to the Pm-group. Conclusions: our study is the first to compare the differences between the two most prevalent entities of NF. The results demonstrate better prognosis for Pm-NF, with minimal ICU stay, lower mortality, and lower use of vasopressors.

scholarly journals Polymicrobial and Monomicrobial Necrotizing Fasciitis: Clinical, Laboratory, Radiology, Pathological Hallmark and Differences, a Retrospective Analysis

2021 ◽  
Author(s):  
Eviatar Naamany ◽  
Shachaf Shiber ◽  
Hadar Daskin-Bitan ◽  
Dafna Yahav ◽  
Jihad Bishara ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Necrotizing Fasciitis ◽  
Clinical Laboratory ◽  
Medical Center ◽  
High Morbidity ◽  
Icu Admission ◽  
Duration Of Hospitalization ◽  
Life Threatening ◽  
Microbial Groups ◽  
Vasopressor Use

Abstract Background: Necrotizing fasciitis(NF) is a life-threatening infection with high morbidity and mortality rates which should be diagnosed and treated with surgical and antibiotic therapy. Many studies have addressed NF and its subtypes, but few have reviewed the clinical, radiological and pathological differences between the poly-microbial and the mono-microbial groups. Objective: The objective of our study is to describe a relatively large cohort of patients with NF and study and compare the clinical, radiological and pathological differences between the poly-microbial(Pm) and the mono-microbial(Mm) groups.Methods: The charts of hospitalized patients with NF diagnosis from 2002-2019 at the Rabin Medical Center were reviewed. The primary outcome was all-cause mortality at 90 days, secondary outcomes included duration of hospitalization, intensive care unit(ICU) admission, LRINEC score and the need for vasopressor use. Results: 81 patients with NF were included in the study, 54(66.6%) had Mm growth and 27(33.3%) had Pm growth. There were no significant differences between the two groups in the 90 days mortality, and moreover in hospital mortality was also insignificantly different. In a multivariate analysis, we found that 90 days mortality was more prevalent in the Mm group compared to Pm group. In addition, we found that in hospital mortality, ICU admission and vasopressors use were more frequent among the Mm-group compared to the Pm-group. Conclusions: our study is the first to compare the differences between the two most prevalent entities of NF. The results demonstrate better prognosis for Pm-NF, with minimal ICU stay, lower mortality, and lower use of vasopressors.

scholarly journals Polymicrobial and monomicrobial necrotizing soft tissue infections: comparison of clinical, laboratory, radiological, and pathological hallmarks and prognosis. A retrospective analysis

2021 ◽  
Vol 6 (1) ◽  
pp. e000745
Author(s):  
Eviatar Naamany ◽  
Shachaf Shiber ◽  
Hadar Duskin-Bitan ◽  
Dafna Yahav ◽  
Jihad Bishara ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Clinical Laboratory ◽  
Medical Center ◽  
High Morbidity ◽  
Risk Indicator ◽  
Pathological Features ◽  
Disease Group ◽  
Level Of Evidence ◽  
Icu Admission ◽  
Polymicrobial Disease

BackgroundNecrotizing soft tissue infection (NSTI) is a life-threatening infection associated with high morbidity and mortality. Treatment consists of surgery and antibiotics. Many studies have addressed NSTI and its subtypes, but few have reviewed the clinical, radiological, and pathological differences between the polymicrobial and monomicrobial diseases. The objective of our study was to evaluate the clinical, radiological, and pathological features of patients with polymicrobial (NSTI I) and monomicrobial (NSTI II) infections and their association with outcome.MethodsThe cohort consisted of patients hospitalized with NSTI at a tertiary medical center in 2002–2019. The medical charts were reviewed for clinical, radiological, and pathological features. Findings were compared between patients in whom blood/tissue bacterial cultures yielded one or more than one pathological isolate. The primary clinical outcome measure of the study was all-cause mortality at 90 days. Secondary outcomes were duration of hospitalization, intensive care unit (ICU) admission, score on the LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis), and need for vasopressor treatment.ResultsA total of 81 patients met the inclusion criteria: 54 (66.6%) with monomicrobial NSTI and 27 (33.3%) with polymicrobial NSTI. There were no significant between-group differences in in-hospital and 90-day mortality. On multivariate analysis, the monomicrobial disease group had a significantly higher 90-day mortality rate in addition to higher rates of in-hospital mortality, ICU admission, and vasopressor use than the polymicrobial disease group.ConclusionOur study is the first to compare the clinical, radiological, and pathological differences between the two most common types of NSTI. The results demonstrate better prognosis for polymicrobial NSTI, with minimal ICU stay, lower mortality, and lower use of vasopressors.Level of evidencePrognostic and epidemiological, level III.

Contemporary outcomes for adults with AML requiring ICU admission.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 7025-7025
Author(s):  
Danielle Hammond ◽  
Koji Sasaki ◽  
Alexis Geppner ◽  
Fadi Haddad ◽  
Shehab Mohamed ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Cancer Center ◽  
Hospital Death ◽  
Entire Cohort ◽  
Morbidity Burden ◽  
Icu Admission ◽  
Poor Risk ◽  
Line Therapy ◽  
Co Morbidity ◽  
Life Threatening

7025 Background: Patients (pts) with AML frequently encounter life-threatening complications requiring transfer to an intensive care unit (ICU). Methods: Retrospective analysis of 145 adults with AML requiring ICU admission at our tertiary cancer center 2018-19. Use of life-sustaining therapies (LSTs) and overall survival (OS) were reported using descriptive statistics. Logistic regression was used to identify risk factors for in-hospital death. Results: Median age was 64 yrs (range 18-86). 47% of pts had an ECOG status of ≥ 2 with a median of at least 1 comorbidity (Table). 117 pts (81%) had active leukemia at admission. 68 pts (47%) had poor-risk cytogenetics (CG) and 32 (22%) had TP53-mutated disease. 61 (42%), 27 (19%) and 57 pts (39%) were receiving 1st, 2nd and ≥ 3rd line therapy. 33 (23%) and 70 pts (48%) were receiving intensive and lower-intensity chemotherapy, respectively, and 77 pts (53%) were concurrently on venetoclax. Most common indications for admission were sepsis (32%), respiratory failure (24%) and leukocytosis (12%); Table outlines additional ICU admission details. Median OS from the date of ICU admission was 2.0 months (mo) for the entire cohort and 6.9, 1.6 and 1.2 mo in pts with favorable-, intermediate- and poor-risk CG. Median OS of pts receiving frontline vs. ≥ 2nd line therapy was 4.2 vs. 1.4 mo (P<0.001). Median OS in pts requiring 0-1 vs. 2-3 LSTs was 4.1 vs. 0.4 mo (P<0.001). OS was not different by age, co-morbidity burden nor therapy intensity. In a multivariate analysis that included SOFA scores, only adverse CG (OR 0.35, P = 0.028), and need for intubation with mechanical ventilation (IMV; OR 0.19, P = 0.009) were associated with increased odds of in-hospital mortality. Conclusions: A substantial portion of pts with AML survive their ICU admission with sufficient functionality to return home and receive subsequent therapy. In contrast to general medical populations, age, co-morbidities, and SOFA scores were not independently predictive of in-hospital mortality. Disease CG risk and the need for IMV were the strongest predictors of ICU survival. This suggests that many pts with AML can benefit from ICU care.[Table: see text]

Comparison of Vasopressor Duration in Septic Shock Patients With and Without Cirrhosis

2020 ◽  
pp. 106002802098072
Author(s):  
Melissa M. Durst ◽  
Elizabeth A. Eitzen ◽  
Scott T. Benken
Keyword(s):  
Septic Shock ◽  
Hospital Mortality ◽  
Medical Center ◽  
Cohort Analysis ◽  
Academic Medical Center ◽  
Treatment Strategies ◽  
Severity Of Illness ◽  
Discharge Disposition ◽  
Increase Risk ◽  
Vasopressor Use

Background Patients with cirrhosis have immune dysfunction, altered inflammatory response, and hemodynamic changes which increase risk of septic shock and potentially prolong management with fluids, vasopressors, and other therapies. Due to limited available guidance, this study aimed to characterize vasopressor use in patients with cirrhosis in relation to patients without cirrhosis in septic shock. Methods This was a retrospective matched cohort analysis of 122 patients admitted to the intensive care unit (ICU) at an academic medical center from January 2015 to November 2017. Patients were grouped based on the presence or absence of cirrhosis and matched based on severity of illness scoring. The primary outcome was vasopressor duration. Secondary comparisons included total vasopressor requirement, length of hospital and ICU stay, in-hospital mortality, change in organ function, and discharge disposition. Results The group with cirrhosis had significantly longer median (interquartile range [IQR]) durations of vasopressor therapy compared with the group without cirrhosis (86.0 [42.0-164.5] vs 39.0 [14.5-82.0] hours; P = 0.003) leading to increased median (IQR) vasopressor exposure (71.7 [15.5-239.5] vs 24.7 [5.3-77.9] mg norepinephrine [NE] equivalents; P = 0.003). No difference was found in in-hospital mortality between groups. However, regression analysis showed vasopressor exposure was associated with in-hospital mortality. Conclusion and Relevance Patients with cirrhosis in septic shock have increased vasopressor durations and overall requirements compared with patients without cirrhosis. Increased durations and requirements is associated with poorer outcomes independent of presence of cirrhosis. Future studies are needed to improve vasopressor treatment strategies and end points utilized in cirrhosis.

Abstract 18700: Impact of Gender on Clinical Outcomes in Adults With In-hospital Cardiac Arrest

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Jonah Garry ◽  
Robert Nguyen ◽  
Elinor Schoenfeld ◽  
Sam Parnia ◽  
Jignesh Patel
Keyword(s):  
Cardiac Arrest ◽  
Clinical Laboratory ◽  
Medical Center ◽  
Spontaneous Circulation ◽  
Outcome Data ◽  
Chronic Obstructive ◽  
High Morbidity ◽  
Men And Women ◽  
The Impact ◽  
Hospital Cardiac Arrest

Background: Despite numerous advances in the delivery of resuscitative care, in-hospital cardiac arrest (IHCA) continues to be associated with high morbidity and mortality. We sought to study the impact of gender on return of spontaneous circulation (ROSC) and survival to discharge in patients with IHCA. Methods: The study population included 255 consecutive patients who underwent ACLS-guided resuscitation from January 2012- December2013 for IHCA at an academic tertiary medical center. Baseline demographic, clinical, laboratory, and clinical outcome data were recorded. Outcomes of interest included presence of sustained ROSC (defined as ROSC > 20 minutes) and survival to discharge. Results: Of the 255 patients studied, 96 (37.6%) were women and 159 (62.4%) were men. No difference in age, race, or ethnicity was noted between men and women. Women were shorter (160cm vs 174cm, p<0.001) and had lower weight (78kg vs 89kg, p<0.001), but had a trend towards higher body mass index (31.4 kg/m2 vs 29.4kg/m2, p=0.087). Women had lower rates of peripheral vascular disease (15.6% vs 27.0%, p=0.035) and hyperlipidemia (26.4% vs 41.6%, p=0.017). Rates of other comorbidities, including cardiovascular disease, chronic obstructive pulmonary disease, congestive heart failure, stroke, diabetes mellitus, chronic kidney disease, and hypertension were similar in men and women. Clinical presentation of IHCA, in particular, the initial rhythm, location of IHCA, duration of cardiopulmonary resuscitation, and laboratory results at the time of IHCA was similar in both men and women. With respect to outcomes, women were noted to have a trend toward lower rates of sustained ROSC (45.8% vs 57.9%, p=0.062) but no difference in survival to discharge (22.9% vs 27.0%, p=0.464). In multivariate analysis, gender was not an independent predictor of sustained ROSC or survival to discharge. Conclusion: Gender is not independently predictive of ROSC or survival to discharge in adults with IHCA.

Vibrio vulnificus-Induced Necrotizing Fasciitis Complicated by Multidrug-Resistant Acinetobacter baumannii Infection: Efficacy of Chemical Necrectomy Using 40% Benzoic Acid

2021 ◽  
pp. 153473462110043
Author(s):  
Bretislav Lipový ◽  
Radomir Mager ◽  
Filip Raška ◽  
Marketa Hanslianová ◽  
Josef Blažek ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Benzoic Acid ◽  
Necrotizing Fasciitis ◽  
Acinetobacter Baumannii ◽  
Soft Tissue Infection ◽  
Vibrio Vulnificus ◽  
Tissue Infection ◽  
Diabetic Patients ◽  
High Morbidity ◽  
Life Threatening

Necrotizing fasciitis is a life-threatening skin and soft tissue infection associated with high morbidity and mortality in adult patients. This infection can present as either type 1 infection caused by a mixed microflora ( Streptococci, Enterobacteriacae, Bacteroides sp., and Peptostreptococcus sp.), most commonly developing in patients after surgery or in diabetic patients, or as type 2. The latter type is monomicrobial and, usually, caused by group A Streptococci. Rarely, this type can be also caused by other pathogens, such as Vibrio vulnificus. V vulnificus is a small mobile Gram-negative rod capable of causing 3 types of infections in humans—gastroenteritis, primary infection of the vascular bed, and wound infections. If infecting a wound, V vulnificus can cause a life-threatening condition—necrotizing fasciitis. We present a rare case of necrotizing fasciitis developing after an insect bite followed by exposure to the seawater. Rapid propagation of the infectious complication in the region of the right lower limb led to a serious consideration of the necessity of amputation. Due to the clearly demarcated necroses and secondary skin and soft tissue infection caused by a multiresistant strain of Acinetobacter baumannii, we, however, resorted to the use of selective chemical necrectomy using 40% benzoic acid—a unique application in this kind of condition. The chemical necrectomy was successful, relatively gentle and thanks to its selectivity, vital parts of the limb remained preserved and could have been subsequently salvaged at minimum blood loss. Moreover, the antimicrobial effect of benzoic acid led to rapid decolonization of the necrosis and wound bed preparation, which allowed us to perform defect closure using split-thickness skin grafts. The patient subsequently healed without further complications and returned to normal life.

scholarly journals Characteristics, Outcomes and 60-Day Hospital Mortality of ICU Patients with COVID-19 and Acute Kidney Injury

Kidney360 ◽  
2020 ◽  
Vol 1 (12) ◽  
pp. 1339-1344 ◽  
Author(s):  
Jyotsana Thakkar ◽  
Sudham Chand ◽  
Michael S. Aboodi ◽  
Anirudh R. Gone ◽  
Emad Alahiri ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Hospital Mortality ◽  
Medical Center ◽  
Invasive Mechanical Ventilation ◽  
Kidney Injury ◽  
Day Hospital ◽  
Icu Admission ◽  
High Incidence ◽  
Stage 1

BackgroundAKI has been reported in patients with COVID-19 pneumonia and it is associated with higher mortality. The aim of our study is to describe characteristics, outcomes, and 60-day hospital mortality of patients with COVID-19 pneumonia and AKI in the intensive care unit (ICU).MethodsWe conducted a retrospective study in which all adult patients with confirmed COVID-19 who were admitted to ICUs of Montefiore Medical Center and developing AKI were included. The study period ranged from March 10 to April 11, 2020. The 60-day follow-up data through June 11, 2020 were obtained.ResultsOf 300 adults admitted to the ICUs with COVID-19 pneumonia, 224 patients (75%) presented with AKI or developed AKI subsequent to admission. A total of 218 (97%) patients required invasive mechanical ventilation for moderate to severe acute respiratory distress syndrome (ARDS). A total of 113 (50%) patients had AKI on day 1 of ICU admission. The peak AKI stages observed were stage 1 in 49 (22%), stage 2 in 35 (16%), and stage 3 in 140 (63%) patients, respectively. Among patients with AKI, 114 patients (51%) required RRT. The mortality rate of patients requiring RRT was 70%. Of the 34 patients who were survivors, 25 (74%) were able to be weaned off RRT completely before hospital discharge. Nonsurvivors were older and had significantly higher admission and peak creatinine levels, admission hemoglobin, and peak phosphate levels compared with survivors. The 60-day hospital mortality was 67%.ConclusionsCOVID-19 requiring ICU admission is associated with high incidence of severe AKI, necessitating RRT in approximately half of such patients. The majority of patients with COVID-19 and AKI in ICU developed moderate to severe ARDS, requiring invasive mechanical ventilation. Timing or severity of AKI did not affect outcomes. The 60-day hospital mortality is high (67%). Patients with AKI requiring RRT have high mortality, but survivors have good rates of RRT recovery.PodcastThis article contains a podcast at https://www.asn-online.org/media/podcast/K360/2020_12_31_KID0004282020.mp3

scholarly journals Intensive Care Unit and Hospital Outcomes of Patients Admitted with Blastomycosis: A 14-Year Retrospective Study

2021 ◽  
Author(s):  
Yahya Almodallal ◽  
Adham K Alkurashi ◽  
Hasan Ahmad Hasan Albitar ◽  
Hussam Jenad ◽  
Suartcha Prueksaritanond ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Renal Replacement Therapy ◽  
Hospital Mortality ◽  
Replacement Therapy ◽  
Distress Syndrome ◽  
Clinical Presentation ◽  
Admission Rate ◽  
Icu Admission ◽  
Life Threatening

Abstract Introduction: Blastomycosis is an uncommon; potentially life threatening granulomatous fungal infection. The aim of this study is to report hospital and intensive care unit (ICU) outcomes of patients admitted with blastomycosis. Methods: All patients admitted for treatment of blastomycosis at the Mayo Clinic-Rochester, Minnesota between 01/01/2006 and 09/30/2019 were included. Demographics, comorbidities, clinical presentation, ICU admission, and outcomes were reviewed.Results: A total of 84 Patients were identified with 93 unique hospitalizations primarily for blastomycosis. The median age at diagnosis was 49 (IQR 28.1-65, range: 6-85) years and 56 (66.7%) were male. The most frequent comorbidities incl­uded hypertension (n=28, 33.3%); immunosuppressed state (n=25, 29.8%) and diabetes mellitus (n=21, 25%). The lungs were the only organ involved in 56 (66.7%) cases and the infection was disseminated in 19 (22.6%) cases. A total of 29 patients (34.5%) underwent ICU admission due to complications of blastomycosis. ICU related events included mechanical ventilation (n=21, 25%), acute respiratory distress syndrome (ARDS) (n=13, 15.5%), tracheostomy (n=9, 10.7%), renal replacement therapy (n=8, 9.5%), and extracorporeal membrane oxygenation (ECMO) (n=4, 4.8%). A total of 12 patients (14.3%) died in the hospital; all of whom had undergone ICU admission. In-hospital mortality was associated with renal replacement therapy (RRT) (P=0.0255).Conclusions: Blastomycosis is a serious, potentially life-threatening infection that results in significant morbidity and mortality with a 34.5% ICU admission rate. Renal replacement therapy was associated with in-hospital mortality.

scholarly journals Pre-operative External Ventricle Drainage Improves Neurological Outcomes for Patients with Traumatic Intracerebellar Hematomas

2020 ◽  
Author(s):  
Bao Wang ◽  
Shun-nan Ge ◽  
Hao Guo ◽  
Fei Gao ◽  
Ying-wu Shi ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Medical Center ◽  
External Ventricular Drainage ◽  
Neurological Function ◽  
High Morbidity ◽  
Acute Hydrocephalus ◽  
Hematoma Evacuation ◽  
Stay Time ◽  
The Difference ◽  
Gcs Score

Abstract Background: Traumatic intracerebellar hematoma (TICH) is a very rare entity but with high morbidity and mortality rate, and there is no consensus on its optimal surgical management. In particular, whether and when to place external ventricle drainage in TICH patients without acute hydrocephalus pre-operation is still controversial.Methods: A single-institutional, retrospective analysis of total 47 TICH patients with craniectomy hematoma evacuation in a tertiary medical center from January 2009 to October 2020 was performed. Primary outcomes were mortality in hospital and neurological function evaluated by GOS at discharge and 6 months after the ictus. The special attention was paid to the significance of external ventricular drainage (EVD) in TICH patients without acute hydrocephalus on admission.Results: Analysis of the clinical characteristics of the TICH patients revealed that the odds use of EVD was seen in patients with IVH (p=0.03), fourth ventricle compression (p=0.02), and acute hydrocephalus (p<0.01). Placement of EVD at the bedside can significantly improve the GCS score before craniotomy (p=0.02), as well as the neurological score at discharge (p=0.045) and 6 months (p=0.04). Compared with the only hematoma evacuation (HE) group, there is a trend that EVD can reduce hospital mortality (27.6% vs. 38.9%) and decrease the occurrence of delayed hydrocephalus (4.8% vs. 18.2%), although the difference is not statistically significant. In addition, EVD can reduce the average NICU stay time (p=0.04, 4.9 ± 5.1 vs. 9.4 ± 6.3), but has no effect on the total length of stay. Moreover, our data showed that EVD did not increased the risk of associated bleeding and intracranial infection. Interestingly, in terms of neurological function at discharge and 6-month after the ictus (p=0.01), even though without acute hydrocephalus on admission, the TICH patients can still benefit from EVD insertion. Conclusion: For TICH patients, EVD is safe and can significantly improve neurological prognosis. Especially for patients whose GCS dropped by more than 2 points before operation, EVD can significantly improve the patient's GCS score, reduce the risk of herniation, and gain more time for surgical preparation. Even for TICH patients without acute hydrocephalus on admission CT scan, EVD placement still has positive clinical significance. However, future studies with larger sample size are warranted to confirm whether EVD can reduce in-hospital mortality and the risk of delayed hydrocephalus in TICH.

scholarly journals Comparison of CRB/CRB-65, qSOFA, and SIRS for Risk Prediction in Patients with Urinary Tract Infection

2020 ◽  
Author(s):  
Sung Jin Bae ◽  
Jae Hee Lee ◽  
Yoon Hee Choi
Keyword(s):  
Emergency Department ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Hospital Mortality ◽  
Sensitivity And Specificity ◽  
Early Recognition ◽  
Medical Center ◽  
Baseline Characteristic ◽  
Icu Admission

Abstract Background: Early recognition of sepsis is critical for improving patient outcomes. In approximately 20%-30% of patients, sepsis resulted from urinary tract infection (UTI). This study aimed to investigate the effectiveness of CRB (confusion, respiratory rate, blood pressure), CRB-65, and quick sequential organ failure assessment (qSOFA) in predicting intensive care unit (ICU) admission and in-hospital mortality of patients with UTI and compare them with Systemic Inflammatory Response Syndrome (SIRS). Methods: This retrospective cohort study included patients with UTI who visited the emergency department of a single medical center between February 2018 and March 2020. Baseline characteristic data were obtained and compared with the prevalence of ICU admission and in-hospital mortality. The effectiveness of CRB, CRB-65, qSOFA, and SIRS as indicators of ICU admission and in-hospital mortality was evaluated using the area under the receiver operating characteristic (AUROC) curve. Results: Overall, 1151 patients were included in this study, of whom 132 (11.5%) were admitted to the ICU and 30 (2.6%) succumbed to in-hospital mortality. AUROC values of CRB, CRB-65, and qSOFA as predictors of ICU admission and in-hospital mortality were similar. The CRB score of ≥1 had a sensitivity and specificity of 71.3% and 73.5%, respectively, for ICU admission and 66.7% and 69.2%, respectively, for in-hospital mortality. The CRB-65 score of ≥2 had a sensitivity and specificity of 61.2% and 80.9%, respectively, for ICU admissions and 60% and 76.9%, respectively, for in-hospital mortality. The qSOFA score of ≥1 had a sensitivity and specificity of 71.3% and 79.6%, respectively, for ICU admission and 66.7% and 74.8%, respectively, for in-hospital mortality. Conclusion: CRB, CRB-65, and qSOFA were more effective predictors than SIRS for patients with UTI. CRB, CRB-65, and qSOFA had similar general values for predicting outcomes in patients with UTI in the emergency department.

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