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논문분류	춘계학술대회 초록집
제목	Clinical Predictors of Urological Intervention in Children with a First Febrile Urinary Tract Infection
저자	Jin-Soon Suh
출판정보	2026; 2026(1):
키워드	Child, Urinary tract infection, Kidney scarring, Ultrasonography, Risk factors
초록	Objectives: Urological interventions after pediatric febrile urinary tract infection (UTI) are guided by clinicians’ expert judgement based on risk factors for vesicoureteral reflux, recurrent UTI, and renal scarring. We sought clinical predictors of undergoing a urological intervention using variables available at the time of an outpatient UTI diagnosis. Methods: We retrospectively reviewed the medical records of 2,155 children aged <10 years who experienced their first febrile UTI. Among the clinical factors assessed at the time of UTI diagnosis, those associated with subsequent urological intervention were identified using multivariate analysis. The sensitivity and specificity of renal and bladder ultrasonography (RBUS) for predicting urological intervention were evaluated when RBUS was performed universally and selectively based on the identified predictors. Results: Of the 2,155 children, 88 (4.1%) eventually underwent a urological intervention. Hospitalization or antibiotic use within the preceding month (p < 0.001), age ≥24 months (p < 0.001), infection with a non-E. coli pathogen (p < 0.001), failure to achieve defervescence ≤2 days after antibiotic therapy (p = 0.038), and peak body temperature >39.0 ℃ (p = 0.007) were independently associated with undergoing a urological intervention. Among the 2,047 children who underwent RBUS, 993 (48.5%) had at least one identified predictor. Universal (n = 2,047) and selective (n = 993) RBUS demonstrated similar sensitivity and specificity for predicting urological intervention, while selective use reduced RBUS utilization by approximately 50%. Conclusion: Applying clinical predictors of urological intervention may be used to guide selective RBUS in children after their first febrile UTI.
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