Osmangazi University score to reduce ionizing radiation in renal colic patients in emergency department

Abstract

Objective: Computerized tomography remains the gold standard imaging in renal colic patients. In this study, we develop a scoring system to select patients in emergency department for unnecessary computerized tomography imaging in order to decrease radiation exposure. Methods: Computerized tomography imaging of patients with renal colic in emergency department were retrospectively reviewed. Symptoms, laboratory results were recorded. Significant parameters were determined by univariate and multivariate analysis. Coefficients were found to obtain score points and receiver operating curve was used to find a cut-off value. Results: A total of 123 patients with a mean age of 42 years (18-75 years) were enrolled in the study. About, 20.3% of patients were stone-free in computerized tomography. Mean stone size was 6.1 ± 1.89 mm. According to analysis, four parameters were significant; nausea, stone history, creatinine, and hematuria with a total score 9 called as Osmangazi University STONE score. Cut-off value was found as >3, which computerized tomography imaging is recommended. Conclusion: Osmangazi University STONE score is useful and simple tool in emergency department to reduce unnecessary computerized tomography imaging in renal colic patients and also lowers cost and ionizing radiation exposure.

The Use of Visual Analogue Scale Score as a Predicting Tool in Differentiating Renal Colic From Lumbar Back Pain

“…Renal colic due to urinary stones is commonly seen in both the urology clinic and the emergency department, and often has a similar manifestation with LBP [ 6 ]. Nowadays, diagnosis of renal colic can be made with high accuracy by using CT [ 5 ]. In evaluating such patients, clinicians encounter many factors such as the requirement of providing the most accurate diagnosis, meeting patients’ expectations, radiation exposure, and the procedures’ cost covered by insurance companies, especially in developed countries.…”

“…In 2017, Fukuhara et al developed CHOKAAI (distension of kidney Capsule, Hydronephrosis, Occult blood in urine, Kidney stone history, Adult, Age, Diminution of pain within six hours) scoring system [ 10 ]. In 2018, Başeskioğlu et al designed the Osmangazi University Score, which used nausea, a history of stones, Cre, and hematuria [ 5 ]. In a meta-analysis that included the aforementioned scoring systems along with six others, Mirfazaelian et al found the STONE scoring system to be superior to others [ 1 , 19 - 22 ].…”

“…Although ultrasonography (US) is the first-line diagnostic method in stone diagnosis, it is highly dependent on the attention and experience of the person performing it, and its sensitivity remains low, especially in detecting ureteral and kidney stones [ 3 ]. Therefore, non-contrast computed tomography (CT), a gold standard diagnostic method, is frequently used to reach a definitive diagnosis, but its use increases the cost and exposure to radiation [ 1 , 4 , 5 ].…”

“…Clinicians have also tried to predict urinary stones in patients presenting with flank pain with the aim of reducing radiation exposure and cost. Some researchers have worked on this issue and tried to introduce some scoring systems [ 5 , 9 - 12 ]. However, none of these scoring systems provide a prediction based on the physical examination of the patient upon initial presentation to the outpatient clinic.…”

What are the clinical effects of the different emergency department imaging options for suspected renal colic? A scoping review

“…A total of 14 studies sought to develop and validate prediction rules with the goal of predicting the likelihood that a patient with flank pain has ureterolithiasis (Table 6 in Supplement B). 24,30,32,[48][49][50][51][52][53][54][55][56][57][58] Of the 14 studies included, 1 was a 2019 meta-analysis that sought to assess the performance of existing prediction rules. The STONE score and the CHOKAI score were most frequently evaluated.…”