Does the use of bedside ultrasonography reduce emergency department length of stay for patients with renal colic?: a pilot study

Park, Yong Hoon; Jung, Ru Bi; Lee, Young Geun; Hong, Chong Kun; Ahn, Jung Hwan; Shin, Tae Yong; Kim, Young Sik; Ha, Young Rock

doi:10.15441/ceem.15.109

Cited by 16 publications

(10 citation statements)

References 14 publications

(20 reference statements)

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“…The importance of POCUS in evaluating patients with renal colic is being increasingly recognized [17,18]. However, only a few ultrasonography algorithms for managing patients suspected with ureter stone exist [19,20,21,22,23].…”

Section: Introductionmentioning

confidence: 99%

Usefulness of Protocolized Point-of-Care Ultrasonography for Patients with Acute Renal Colic Who Visited Emergency Department: A Randomized Controlled Study

Kim

et al. 2019

Medicina

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Background and Objectives: Ultrasonography is useful in evaluating patients with renal colic and it has high sensitivity and specificity for diagnosing ureter stones by revealing hydronephrosis. We evaluated the efficacy of point-of-care ultrasonography protocol in managing patients with acute renal colic who visited the emergency department (ED). Materials and Methods: Between March 2019 and July 2019, patients who visited the ED because of renal colic were randomly assigned by date of visit either to the conventional group (CG), who underwent routine diagnostic work-up without ultrasonography, or to the ultrasonography group (UG), who underwent bedside ultrasonography as an initial diagnostic testing. When hydronephrosis was detected in the UG group, a confirmatory non-contrast abdomen computed tomography scan was promptly performed. The ED length of stay, complications, and missed or delayed high-risk diagnosis were evaluated. Results: In total, 128 of 147 analyzed patients were confirmed to have ureter stones. The ED length of stay was significantly lower in the UG group than in the CG group (mean 172 min; 95% confidence interval (CI): 151–194 min vs. mean 234 min; 95% CI: 216–252 min). The medical cost was also remarkably lower in the UG group than in the CG group (259 USD vs. 319 USD; p < 0.001). The incidence of complications within 30 days after visiting ED and missed or delayed high-risk diagnosis were not significantly different between the two groups. Conclusions: We found that protocolized point-of-care ultrasonography in patients with acute renal colic who visited the ED can more effectively reduce the length of stay and medical cost without 30-day complication than usual clinical practice.

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Section: Introductionmentioning

confidence: 99%

Usefulness of Protocolized Point-of-Care Ultrasonography for Patients with Acute Renal Colic Who Visited Emergency Department: A Randomized Controlled Study

Kim

et al. 2019

Medicina

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“…Finally, one large ( n = 2759) study, randomising patients into diagnosis through EP PoCUS, radiologist ultrasound or computed tomography (CT), found no difference in high-risk diagnoses that could be due to missed or delayed diagnosis after 30 days, and showed overall lower cumulative radiation exposure at 6 months for both ultrasound groups compared to the CT group [116]. They also showed a slight, but significant, reduction in ED length of stay, while another study found halving of the length of stay [117].…”

Section: Resultsmentioning

confidence: 99%

Point-of-care ultrasound in primary care: a systematic review of generalist performed point-of-care ultrasound in unselected populations

Sorensen¹,

Hunskaar

2019

Ultrasound J

103

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Background: Both the interest and actual extent of use of point-of-care ultrasound, PoCUS, among general practitioners or family physicians are increasing and training is also increasingly implemented in residency programs. However, the amount of research within the field is still rather limited compared to what is seen within other specialties in which it has become more established, such as in the specialty of emergency medicine. An assumption is made that what is relevant for emergency medicine physicians and their populations is also relevant to the general practitioner, as both groups are generalists working in unselected populations. This systematic review aims to examine the extent of use and to identify clinical studies on the use of PoCUS by either general practitioners or emergency physicians on indications that are relevant for the former, both in their daily practice and in out-of-hours services.Methods: Systematic searches were done in PubMed/MEDLINE using terms related to general practice, emergency medicine, and ultrasound. Results:On the extent of use, we identified 19 articles, as well as 26 meta-analyses and 168 primary studies on the clinical use of PoCUS. We found variable, but generally low, use among general practitioners, while it seems to be thoroughly established in emergency medicine in North America, and increasingly also in the rest of the world. In terms of clinical studies, most were on diagnostic accuracy, and most organ systems were studied; the heart, lungs/ thorax, vessels, abdominal and pelvic organs, obstetric ultrasound, the eye, soft tissue, and the musculoskeletal system. The studies found in general either high sensitivity or high specificity for the particular test studied, and in some cases high total accuracy and superiority to other established diagnostic imaging modalities. PoCUS also showed faster time to diagnosis and change in management in some studies. Conclusion:Our review shows that generalists can, given a certain level of pre-test probability, safely use PoCUS in a wide range of clinical settings to aid diagnosis and better the care of their patients. which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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“…Patients presenting with acute renal colic at the emergency department Authors Year Country Study design No. of patients % Male Mean age ± SD (years) Kim et al [ 13 ] 2018 South Korea Retrospective, observational 798 68.6 48.2 ± 13.3 Desai et al [ 14 ] 2018 USA Retrospective, observational 350 NR NR Türk and Ün [ 15 ] a 2017 Turkey Prospective, observational 516 60.5 37 ± 20.3 Shrestha et al [ 16 ] a 2017 Nepal Retrospective, observational 201 55.2 29 ± 13.5 Odoemene et al [ 17 ] a 2017 Nigeria Prospective, observational 69 76.8 40.4 ± 2.9 Mefford et al [ 18 ] 2017 USA Retrospective, observational 393 69 Median 43 (IQR 32–54) Rapp et al [ 19 ] 2016 USA Retrospective, observational 613 47 49 ± 0.6 Park et al [ 20 ] 2016 South Korea Prospective, RCT 103 66 45.6 ± 12.55 Hernandez et al [ 21 ] 2016 USA Retrospective, observational 536 56 45.9 ± 16.3 <...>…”

Section: Resultsmentioning

confidence: 99%

Prevalence of microhematuria in renal colic and urolithiasis: a systematic review and meta-analysis

et al. 2020

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Background: This systematic review and meta-analysis aims to investigate the prevalence of microhematuria in patients presenting with suspected acute renal colic and/or confirmed urolithiasis at the emergency department. Methods: A comprehensive literature search was conducted to find relevant data on prevalence of microhematuria in patients with suspected acute renal colic and/or confirmed urolithiasis. Data from each study regarding study design, patient characteristics and prevalence of microhematuria were retrieved. A random effect-model was used for the pooled analyses. Results: Forty-nine articles including 15′860 patients were selected through the literature search. The pooled microhematuria prevalence was 77% (95%CI: 73-80%) and 84% (95%CI: 80-87%) for suspected acute renal colic and confirmed urolithiasis, respectively. This proportion was much higher when the dipstick was used as diagnostic test (80 and 90% for acute renal colic and urolithiasis, respectively) compared to the microscopic urinalysis (74 and 78% for acute renal colic and urolithiasis, respectively). Conclusions: This meta-analysis revealed a high prevalence of microhematuria in patients with acute renal colic (77%), including those with confirmed urolithiasis (84%). Intending this prevalence as sensitivity, we reached moderate values, which make microhematuria alone a poor diagnostic test for acute renal colic or urolithiasis. Microhematuria could possibly still important to assess the risk in patients with renal colic.

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Does the use of bedside ultrasonography reduce emergency department length of stay for patients with renal colic?: a pilot study

Cited by 16 publications

References 14 publications

Usefulness of Protocolized Point-of-Care Ultrasonography for Patients with Acute Renal Colic Who Visited Emergency Department: A Randomized Controlled Study

Usefulness of Protocolized Point-of-Care Ultrasonography for Patients with Acute Renal Colic Who Visited Emergency Department: A Randomized Controlled Study

Point-of-care ultrasound in primary care: a systematic review of generalist performed point-of-care ultrasound in unselected populations

Prevalence of microhematuria in renal colic and urolithiasis: a systematic review and meta-analysis

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