Does pain severity predict stone characteristics or outcomes in emergency department patients with acute renal colic?

Gourlay, Katie; Splinter, Graeme D.; Hayward, Jake; Innes, Grant

doi:10.1016/j.ajem.2021.02.049

Cited by 4 publications

(7 citation statements)

References 25 publications

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“…A similar study done by Sasmaz and Kirpat found no correlation between stone size and VAS pain score (r = 0.079, p = 0.123) [ 10 ]. In a study done by Gourlay et al, they found a weak negative association (adjusted OR=0.96) between pain severity and stone width indicating that smaller stones were more symptomatic [ 11 ]. Contrarily, the study by Splinter et al which correlate arrival pain scores with stone size also found that smaller stones caused more pain when compared to larger stones (b=−0.0004; 95% CI: -0.0015; 0.0008) [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…This could be attributed to the more acuteness of obstruction to urinary flow that can be surgically relieved to ease the pain. Contrarily, a study by Gourlay et al did not find any association between the severity of pain and the need for hospitalisation or rescue intervention within 60 days [ 11 ]. A study by Portis et al found that pain severity was an independent predictor of the need for surgical intervention [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Gourlay et al and Splinter et al reported that there was no significant correlation of pain with stone size, location, and patient outcomes. On the other hand, Portis et al in a study found that pain score was an independent predictor of surgical outcome [ 11 - 13 ]. However, a study by Sasmaz and Kirpat found a significant correlation of pain severity with hydronephrosis and biomarkers like C-reactive protein and Neutrophil-Lymphocyte ratio [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Correlation of Severity of Renal Colic With Clinical, Laboratory, and Radiological Parameters: An Emergency Department-Based Prospective Observational Study

Joshi¹,

Kaeley²,

Nagasubramanyam³

et al. 2022

Cureus

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In this study, we investigated the correlation of severity of renal colic with clinical parameters like pain characteristics, haematuria and pyuria, laboratory parameters such as inflammatory markers, and radiological parameters including site and size of stone and hydronephrosis. MethodsThe Visual Analogue Scale (VAS) determined the pain severity. Detailed history and clinicodemographic profiling of the patient was done, laboratory investigations were done, ultrasound and non-contrast computed tomography of kidney-ureter-bladder were done and all the parameters were duly noted and correlated with the pain severity. ResultThe mean age of the 183 patients was 43.96 ± 15.16 years, and 62.8% were male. The patients' mean VAS score at presentation was 8.57 ± 1.08. The mean VAS score was found to be statistically higher in patients having a first episode of renal colic, solitary kidney, pyuria, raised creatinine, severe hydronephrosis, and stones located at the renal pelvis. In addition, higher VAS scores led to more surgical interventions. ConclusionThe correlation of pain severity of renal colic with various parameters can aid in the development of quick diagnostic and therapeutic protocols for patients presenting to the emergency department with renal stone disease. This study shows that pain scores can correlate with various parameters and predict the outcome and complications in these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Correlation of Severity of Renal Colic With Clinical, Laboratory, and Radiological Parameters: An Emergency Department-Based Prospective Observational Study

Joshi¹,

Kaeley²,

Nagasubramanyam³

et al. 2022

Cureus

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“…The aim of the treatment is to relieve the pain effectively and to relieve the obstruction without causing loss of kidney function. 1…”

Section: Introductionmentioning

confidence: 99%

“…The aim of the treatment is to relieve the pain effectively and to relieve the obstruction without causing loss of kidney function. 1 Suspected renal colic accounts for nearly 2% of adult visits to the ED in the United States, and its economic cost is $2.1 million dollars per year. Many imaging methods are used in patients with suspected urolithiasis, mainly ultrasonography (USG), computed tomography (CT), and direct radiography.…”

Section: Introductionmentioning

confidence: 99%

Clinical Score Application for Abdominopelvic Computed Tomography Used in the Diagnosis of Renal Colic Patients

Gonullu

Selvi²,

Bedel³

2022

Ibnosina Journal of Medicine and Biomedical Sciences

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Background To develop risk scoring for the use of computed tomography (CT) imaging using the visual analog scale (VAS), physical examination, and laboratory findings of renal colic patients admitted to the emergency department (ED). Materials and Methods This is prospective observational study. Among the patients who presented to the ED with abdominal or flank pain, patients who were scheduled for CT imaging for urolithiasis were included in the study. The mean VAS pain scores, physical examination findings, laboratory parameters, and macroscopic and microscopic values in urinalysis were compared between the two groups with and without stones on CT. Results Of the 196 urolithiasis patients included in the study, 165 had ureteral stones, 76 had renal stones, and 45 had renal and ureteral stones. While the difference between the urine erythrocyte averages of the two groups was borderline significant (p = 0.04), there was a high difference between the urinary hemoglobin amounts (p < 0.001). In patients with urinary system stone disease, hydronephrosis, and ureteral dilatation, hemoglobin ++ and above were more significant (p < 0.001). For ureteral stones, pain intensity increased as the size increased (r = 0.34 p < 0.001). White blood cells > 10,000 103/mL, and C-reactive protein (CRP) ≤ 5 mg/L were more significant in patients with acute renal colic. Conclusions Although we cannot develop a clinical scoring system for renal colic patients, the meaningful results we found for urinary stone disease can be used in a newly developed scoring system. It can be used in new scoring systems in the ED using a high VAS score, presence and amount of urine hemoglobin, CRP) ≤ 5 mg/L, and creatinine value.

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Nephrolithiasis

Pines

2023

Evidence‐Based Emergency Care

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Does pain severity predict stone characteristics or outcomes in emergency department patients with acute renal colic?

Cited by 4 publications

References 25 publications

Correlation of Severity of Renal Colic With Clinical, Laboratory, and Radiological Parameters: An Emergency Department-Based Prospective Observational Study

Correlation of Severity of Renal Colic With Clinical, Laboratory, and Radiological Parameters: An Emergency Department-Based Prospective Observational Study

Clinical Score Application for Abdominopelvic Computed Tomography Used in the Diagnosis of Renal Colic Patients

Nephrolithiasis

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