Prospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Nephrol. Jun 25, 2025; 14(2): 103035
Published online Jun 25, 2025. doi: 10.5527/wjn.v14.i2.103035
Modified National Early Warning Score 2, a reliable early warning system for predicting treatment outcomes in patients with emphysematous pyelonephritis
Sriram Krishnamoorthy, Gayathri Thiruvengadam, Hariharasudhan Sekar, Velmurugan Palaniyandi, Srinivasan Ramadurai, Senthil Narayanasamy
Sriram Krishnamoorthy, Hariharasudhan Sekar, Velmurugan Palaniyandi, Department of Urology and Renal Transplantation, Sri Ramachandra Institute of Higher Education and Research, Chennai 600116, Tamil Nādu, India
Gayathri Thiruvengadam, Faculty of Allied Health Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai 600116, Tamil Nādu, India
Srinivasan Ramadurai, Senthil Narayanasamy, Department of General Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai 600116, Tamil Nādu, India
Author contributions: Krishnamoorthy S played a major role in the study by conceiving the idea, designing the research framework, and writing the full manuscript; Thiruvengadam G performed the statistical analysis, contributed to manuscript writing, and played a key role in the study's execution; Sekar H, Palaniyandi V, Ramadurai S, and Narayanasamy S were responsible for data collection and management of patients; all authors reviewed, revised, and approved the final manuscript.
Institutional review board statement: No. IEC-NI/13/OCT/36/78 enclosed as attachment.
Clinical trial registration statement: Clinical Trial Registration Statement This study was not a clinical trial and, therefore, does not require registration in a clinical trial database. It is a prospective observational study based on anonymized patient records and involves no prospective interventional procedures. Author Certification By signing below, I confirm that: (1) The clinical trial registration details provided above are accurate and comply with journal policies and international guidelines; (2) If the study does not require registration, the justification provided is valid based on its observational nature; and (3) All authors have reviewed and approved this declaration. Declaration: By signing below, I confirm that the information provided in this Clinical Trial Registration Statement is accurate and aligns with the policies of our institution and journal requirements. Corresponding Author Name: Sriram Krishnamoorthy. Date: 20th February 2025.
Informed consent statement: Informed consent was not required for this study as it is a prospective analysis utilizing anonymized patient data from medical records, with no direct patient interaction or intervention. The study was conducted in accordance with institutional ethical guidelines and regulatory standards for observational research, ensuring patient confidentiality and data protection.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: The data supporting the findings of this study are available from the corresponding author upon reasonable request. Due to ethical and institutional regulations, access to patient-specific data is restricted to ensure confidentiality and compliance with data protection policies.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sriram Krishnamoorthy, Professor, Department of Urology and Renal Transplantation, Sri Ramachandra Institute of Higher Education and Research, 1 Ramachandra Nagar, Porur, Chennai 600116, Tamil Nādu, India. sriramuro@gmail.com
Received: November 6, 2024
Revised: February 21, 2025
Accepted: March 4, 2025
Published online: June 25, 2025
Processing time: 154 Days and 20.7 Hours
Core Tip

Core Tip: We present the most extensive single-centre study on patients diagnosed with emphysematous pyelonephritis (EPN), comprehensively evaluating risk stratification, disease severity, and treatment outcomes. While the traditional National Early Warning Score 2 (NEWS 2) score is a well-established tool for triaging critically ill patients in emergency settings, its ability to predict long-term treatment outcomes in EPN remains limited. The modified NEWS 2 score proposed in this study enhances risk differentiation, allowing for more accurate prognostication and timely clinical decision-making. This refined scoring system enables optimized resource allocation, early intensive care unit admission, and tailored treatment approaches, ultimately improving patient survival and reducing morbidity in EPN.