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 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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Author:Mike WenzelORCiDGND, Marina Deuker, Maria-Noemi WelteGND, Robert Benedikt HöhORCiDGND, Felix Martin PreißerORCiDGND, Till Homrich, Volkhard A. J. KempfORCiDGND, Michael HogardtORCiDGND, Philipp MandelORCiDGND, Pierre I. Karakiewicz, Felix ChunORCiDGND, Luis A. KluthORCiDGND
Parent Title (English):Frontiers in Surgery
Publisher:Frontiers Media
Place of publication:Lausanne
Document Type:Article
Date of Publication (online):2020/12/03
Date of first Publication:2020/12/03
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2020/12/17
Tag:antibiotic treatment; catheter; epididymitis; risk score; suprapubic catheter; transurethral catheter
Issue:Article 609661
Page Number:7
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0