Regional short-term climate variations influence on the number of visits for renal colic in a large urban Emergency Department: results of a 7-year survey

Abstract

The pathogenesis of renal stones is an intricate process and varies widely depending on the composition of stones. There is also a marked geographic variability, strongly attributable to the mean annual temperature (MAT) and, to a lesser extent, on the seasons. Previous investigations report peaks in Emergency Department (ED) visits for renal colic during the summer. The aim of the present investigation is to assess the influence of day-by-day climate changes on the number of visits due to renal colic in our ED (city of Parma, located in the Po river valley, with a temperate continental climate). A total of 8,168 colic episodes were retrieved from our database during a period of 2,557 days (from 1 January 2002 to 31 December 2008). Over the same period 557,990 patients were admitted to our ED, renal colic visits representing 1.46% of the total. The linear regression analysis fitting the mean number of colic visits per day and the mean daily temperature displays a very high and significant correlation (R = 0.88, p < 0.0001). A multiple linear regression analysis between the mean temperature of each of the 30 days preceding the colic episode also shows strong correlations, being the strongest on the 5th-7th days (R = 0.80, p < 0.0001 on the 6th day before the colic episode), and a weaker but highly significant correlation on days 14 (R = 0.77, p < 0.0001) and 20 (R = 0.70, p < 0.0001) before the colic episode. Taken together, these findings suggest a kind of "acceleration" process of stone formation caused by the hot climate and, perhaps, by dietary variations during the summer. This process might trigger a sudden growth of the stone and, finally, the resulting clinical episode.

Efficacy of tamsulosin and silodosin as medical expulsive therapy in the management of distal ureteral stones: a randomized controlled study

“…There has been a significant improvement in the medical management of the ureteric calculi with the introduction of effective medical therapeutic agent in the market. 9 Malan et al first demonstrated the presence of alpha adrenergic receptors in the lumen ureter in 1970. Characteristic distribution of alpha one receptor subtypes in distal, middle and proximal segments is alpha 1d, alpha 1a, and alpha 1b.…”

The number of emergency department visits for psychiatric emergencies is strongly associated with mean temperature and humidity variations. Results of a nine year survey

“…This also holds true, for example, in the correlations found between renal colics and climate variations, since the pathogenesis of renal stones is a complex, time-consuming and multifaceted process, but the abrupt onset of the colic just entails a short period, in a specific clinical and environmental condition. 4,5 Due to lack of data, we could not analyze the possible correlations with other climatic variable, such as winds, 58 day-light 59 and time spent outside. 60 We here describe a heterogeneous sample of patients visited for psychiatric emergencies, and it remains unclear whether different diagnostic subgroups may display similar correlations.…”

“…1 From the middle of the past century, however, this phenomenon has been investigated with more appropriate epidemiological and clinical tools, so that we have now reached a point where we can better analyze some popular beliefs under the light of science. Several studies, with different strength of evidence, have shown that an association may exist between meteorological variables and different human disorders such as stroke, 2,3 renal colic, 4,5 myocardial infarction, 6 atrial fibrillation, [7][8][9][10] asthma, 11,12 and arthritic pain. 13 Subjective experiences referred from patients, including variation in pain thresholds and mood swings associated with weather changes, seem to support the existence of a genuine relationship and pave the way to further research on this topic.…”

Epidemiology

“…This geographic variability has been evaluated to assess whether race, age, education, body mass, or diet affects the frequency data, but ambient temperature and sunlight levels remain the greatest risks [ 68 ]. Following extremely warm and dry temperature swings in the Italy, it has been noted that there is a 1-month window where both the incidence and prevalence of stone disease rise [ 69 ].…”