Findings of Non-enhanced Abdominal Computed Tomography for Pain Management of Acute Renal Colic Patients in the Emergency Department
1Department of Emergency Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, P. R. Korea
2Department of Eergency Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, P. R. Korea
3Department of Emergency Medicine, Konkuk University School of medicine, Konkuk University Medical Centre, 120-1 Neungdong-ro (Hwayang-dong), Gwangjin-gu, Seoul 143-729, P. R. Korea
Online publish date: 16 September 2020
† These authors contributed equally.
Study Objectives: To identify non-enhanced computed tomography (NECT) findings related to repeated requirement of painkiller, hospitalization and revisits within 5 days of discharge among acute renal colic patients. Patients and methods: A retrospective observational study was performed for all patients (age > 18 years) with acute renal colic who visited the emergency department (ED) between 2012 and 2015. NECT findings of acute ureterolithiasis (size, location, hydronephroureter, perinephric infiltrations and soft-tissue rim sign) were analysed for their relationships to repeated administration of painkiller, hospitalization and ED revisit. Results: Of total 862 patients enrolled, 305 (35.4%) required repeated administration of pain medication. In the NECT findings, hydronephroureter was more prevalent in the repeated administration of painkiller group (61.3% vs. 53.7%), but did not show independent relationship. Sixty-eight (7.9%) were hospitalized and 44 (5.1%) returned to the ED. The significant findings associated with hospitalization were hydronephroureter (OR [Odd Ratio] 1.92, 95%CI [Confidence Intervals] 1.04–3.54) and mid (5–7 mm) / large-size (> 7mm) ureteral stones (OR 2.66, 95% CI 1.49–4.76 and OR 4.78, 95% CI 1.80–12.70). The soft-tissue rim signs (OR 2.16, 95%CI 1.07–4.37) and proximal/mid location of stones (OR 3.21, 95% CI 1.26–8.20 and OR 2.53, 95% CI 1.19–5.37) were independently associated with ED revisit. Conclusions: Among the NECT findings of acute ureterolithiasis, hydronephroureter and stones > 5 mm in size were independently associated with the need of hospitalization. The soft-tissue rim sign and proximal/mid location of stones were independently associated with ED revisit within 5 days.
Urolithiasis, Renal colic, Computed tomography, Radiology, Emergency departments
Dong Hyuk Shin,Young Hwan Lee,Sang O Park. Findings of Non-enhanced Abdominal Computed Tomography for Pain Management of Acute Renal Colic Patients in the Emergency Department. Signa Vitae. 2020.doi:10.22514/sv.2020.16.0056.
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