Abstract Emphysematous pyelonephritis (EPN) is a rare but life-threatening necrotizing infection of the kidney, frequently associated with diabetes and obstructive uropathy. Early identification of high-risk patients is crucial for guiding appropriate management, including intensive care unit (ICU) admission, drainage, or nephrectomy. While radiological classification systems like Huang-Tseng remain widely used, they do not sufficiently predict systemic deterioration. Recent years have seen the development of various prognostic scoring systems, including general tools like qSOFA (Quick Sequential Organ Failure Assessment), National Early Warning Score (NEWS), and REMS (Rapid Emergency Medicine Score), as well as EPN-specific models such as the Global Research in Emphysematous Pyelonephritis (GREMP) score, Stanley score, and Mittal score. These models integrate clinical, laboratory, and imaging data to provide more accurate risk stratification. Among them, NEWS and GREMP have shown high predictive performance in ICU admission and mortality. However, external validation is still needed for many of these tools. This review summarizes current evidence on EPN scoring systems and advocates for an integrated prognostic approach to improve clinical outcomes.
Erkan Arslan (Mon,) studied this question.