Renal colic in Pisa emergency department: epidemiology, diagnostics and treatment patterns

Abstract

The present investigation aimed to point out some epidemiological and clinical features of renal colic in our region. All emergency department (ED) visits performed from 1 January to 31 December 2005 were reviewed to select those with diagnosis of renal colic or kidney stones. There were 70,621 visits to the University of Pisa ED. Renal colic or stone were diagnosed in 696 cases (1%); 21.6% of them were recurrent stone formers; the males to female ratio was 1.4-1. The age distribution showed a higher rate from 25 to 44 years of age, whereas seasonal distribution showed a higher risk during summer months, particularly in July. Ultrasonography (US) was the only examination in 70.2% cases, it was coupled with plain abdomen X-ray (KUB) in 10% of the cases. NSAIDs were always used (100%), sometimes in association with opiate (15.8%) or with anti-cholinergic (26.5%) medications. The data of our investigation are in a substantial agreement with the reported literature as far as concerns the main epidemiological features of renal colic and its treatment. On the contrary, the diagnostic approach is mainly based on US whereas KUB is rarely performed. Until the 31st of December 2005, CT-scan was not used as the first and only imaging study in cases of renal colic. This different diagnostic approach may be linked to financial and cultural reasons, and structural and functional organization of the National Health Service facilities.

STONE PLUS: Evaluation of Emergency Department Patients With Suspected Renal Colic, Using a Clinical Prediction Tool Combined With Point-of-Care Limited Ultrasonography

“…2 Despite the significant increase in CT use for renal colic, there has not been a significant change in patient-centered outcomes, including hospital admissions or identification of alternate diagnoses. 3,4 Ultrasonography use in patients with suspected renal colic is common outside the United States, but CT scanning remains the first-line imaging modality for renal colic in US EDs. [5][6][7] Although consultant-performed ultrasonography may be obtained, point-of-care limited ultrasonography (PLUS) offers immediate information at the bedside and is available continuously.…”

Epidemiology and Outcomes of Acute Flank Pain in University-Affiliated Regional Emergency Medical Centers

“…The male to female ratio for urinary stones was 2:1, with the highest incidence in the early 50s and 60s [20,21]. In this study, males were more likely to develop urinary stones than females, but they did not differ from the other studies when compared with the average age if the rates were not so different.…”

“…In a recent Korean study, the symptoms of flank pain showed an important circadian pattern with a morning peak and an afternoon dip [12]. The time of morning peak, as reported by Cupisti and colleagues [21], was between 9 am and 12 pm. Urinary stone formation may be affected by many factors, such as stone-forming components, urinary pH, as well as inhibitors and promoters of crystallization.…”

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

“…In an epidemiological survey of renal colic in a large urban ED, Cupisti et al [30] find a seasonal distribution with a higher risk during summer months, particularly in July. More recently, Pincus et al [31] find that the summer rate is significantly greater than the winter rate in a large urban ED (1.53 vs. 1.24 presentations/day, rate difference 0.29, 95% confidence interval 0.15-0.43, p \ 0.001).…”