Dual-score framework: National Early Warning Score 2 and quick Sequential Organ Failure Assessment scores in acute pyelonephritis

Table 1 Baseline patient characteristics, key predictors and clinical differences stratified by intensive care unit admission in acute pyelonephritis (tertiary care institute in South India, 2023-2025), n (%)

Parameter	Group 1 (n = 105)	Group 2 (n = 115)	95%CI	P value
Age in years (mean ± SD)	56.3 ± 14	56.2 ± 14	53.6-59; 53.6-58.8	0.96
Female sex	61 (58.1)	62 (53.9)	48.7-67.5; 44.7-63.1	0.53
Fever	105 (100)	57 (49.6)	96.5-100; 40.6-58.7	< 0.001
Flank pain	67 (63.8)	22 (19.1)	54.4-72.5; 12.6-27.1	< 0.001
Pyuria	60 (57.1)	22 (19.1)	47.4-66.3; 12.6-27.1	< 0.001
Diabetes	93 (88.6)	64 (55.7)	81.2-93.9; 46.3-64.9	< 0.001
CKD	19 (18.1)	12 (10.4)	11.5-26.6; 5.5-17.5	0.11
AKI	60 (57.1)	25 (21.7)	47.4-66.3; 15-30.2	< 0.001
Temperature in degrees celsius (mean ± SD)	38.8 ± 0.6	37.7 ± 1.05	38.6-38.9; 37.5-37.9	< 0.001
Pulse in beats/minute (mean ± SD)	109 ± 15	82 ± 7	106-112; 81-83	< 0.001
SBP in mmHg (mean ± SD)	91 ± 10	118 ± 8	89-93; 117-120	< 0.001
RR in breaths/minute (mean ± SD)	28.3 ± 3.5	17.8 ± 2.2	27.6-29; 17.4-18.2	< 0.001
Total WBC count in × 109/L (mean ± SD)	21 ± 2.3	14.8 ± 5.4	20.6-21.4; 13.8-15.8	< 0.001
Platelets in × 109/L (mean ± SD)	141 ± 39	283 ± 77	191.2-222.8; 269-297	< 0.001
BUN in mmol/L (mean ± SD)	17.3 ± 8.9	13.6 ± 7.5	16.6-21.7; 9.2-11.3	< 0.001
Serum creatinine in μmol/L (mean ± SD)	230 ± 106	150 ± 71	188-271; 95-117	< 0.001
NEWS2 score (mean ± SD)	14.7 ± 3.1	1.7 ± 1.3	14.1-15.3; 1.46-1.94	< 0.001
Intervention	105 (100)	51 (44.3)	96.5-100; 35.3-53.7	< 0.001
Duration of stay in days (mean ± SD)	9.2 ± 3.1	3.5 ± 1.3	8.6-9.8; 3.3-3.7	< 0.001
Mortality	13 (12.4)	1 (0.9)	6.8-20; 0.02-5	0.01

CI: Confidence interval: CKD: Chronic kidney disease; AKI: Acute kidney injury; SBP: Systolic blood pressure; RR: Respiratory rate; WBC: White blood cell; BUN: Blood urea nitrogen; NEWS2: National Early Warning Score 2.

Table 2 Multivariate logistic regression analysis for predictors of intensive care unit admission and mortality in acute pyelonephritis (tertiary care institute in South India, 2023-2025)

Parameter	Adjusted OR for ICU admission (95%CI)	P value	Adjusted OR for mortality (95%CI)	P value
Age ≥ 60 years	1.24 (0.78-1.96)	0.35	1.49 (0.72-3.11)	0.28
Female sex	1.13 (0.68-1.87)	0.62	0.98 (0.42-2.31)	0.97
Diabetes mellitus	2.75 (1.40-5.38)	0.003	1.96 (0.84-4.54)	0.12
AKI at admission	3.21 (1.62-6.38)	0.001	2.18 (0.91-5.21)	0.08
Shock (SBP < 90 mmHg)	4.68 (2.12-10.33)	< 0.001	5.96 (2.03-17.54)	0.001
RR ≥ 22 breaths/min	3.89 (1.91-7.91)	< 0.001	2.94 (1.02-8.50)	0.047
Total WBC count ≥ 15 × 109/L	1.62 (0.89-2.94)	0.11	2.01 (0.78-5.16)	0.15
Platelets ≤ 150 × 109/L	2.77 (1.34-5.73)	0.006	3.45 (1.18-10.07)	0.024
Creatinine ≥ 176.8 μmol/L	1.98 (0.95-4.14)	0.07	2.64 (1.01-6.91)	0.048
NEWS2 score ≥ 5	6.91 (2.84-16.83)	< 0.001	1.65 (0.61-4.48)	0.32
qSOFA score ≥ 2	2.14 (0.88-5.20)	0.09	7.83 (2.16-28.39)	0.002

OR: Odds ratio; ICU: Intensive care unit; CI: Confidence interval; AKI: Acute kidney injury; SBP: Systolic blood pressure; RR: Respiratory rate; WBC: White blood cells; NEWS2: National Early Warning Score 2; qSOFA: Quick Sequential Organ Failure Assessment score.