Findings of non-enhanced abdominal computed tomography for pain management of acute renal colic patients in the emergency department
- Authors
- Shin, D.H.[Shin, D.H.]; Lee, Y.H.[Lee, Y.H.]; Park, S.O.[Park, S.O.]
- Issue Date
- Oct-2020
- Publisher
- Pharmamed Mado Ltd
- Keywords
- Computed tomography; Emergency departments; Radiology; Renal colic; Urolithiasis
- Citation
- Signa Vitae, v.16, no.2, pp.69 - 74
- Indexed
- SCIE
SCOPUS
- Journal Title
- Signa Vitae
- Volume
- 16
- Number
- 2
- Start Page
- 69
- End Page
- 74
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/6655
- DOI
- 10.22514/sv.2020.16.0056
- ISSN
- 1334-5605
- Abstract
- 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. © 2020 The Authors. Published by MRE Press.
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