Point-of-Care Ultrasound Shortens Emergency Department Length of Stay for Renal Colic PatientsPoint-of-Care Ultrasound Shortens Emergency Department Length of Stay for Renal Colic Patients A study published in the May 2024 issue of *Emergency Medicine* found that point-of-care ultrasound (PoCUS) is associated with a shorter length of stay (LOS) in the emergency department (ED) for patients with renal colic compared to computed tomography (CT). Background: Renal colic is a common condition characterized by severe abdominal pain caused by obstructed urine flow from a kidney stone. CT is the traditional imaging modality for diagnosing renal colic, but PoCUS is increasingly used as a bedside diagnostic tool. Study Design: This retrospective cohort study included 325 patients diagnosed with renal colic in the ED over 12 months. Patients were divided into four groups: CT alone (n=150), PoCUS alone (n=80), PoCUS plus CT (n=54), and neither (n=41). LOS, infection rates, repeat ED visits, missed significant pathology, and urologic interventions were compared among the groups. Results: * The median LOS was significantly shorter for patients who underwent PoCUS alone (75.0 minutes) compared to CT alone (231.5 minutes) (p < 0.0001). * There were no significant differences in infection rates, repeat ED visits, or missed pathologies among the groups (p > 0.10). * The rate of urologic interventions was higher in the PoCUS plus CT group (25.9%) compared to CT alone (7.3%), PoCUS alone (2.5%), and neither (7.3%) (p < 0.0001). Conclusion: PoCUS is associated with a shorter ED LOS for patients with renal colic without compromising diagnostic accuracy. The higher rate of urologic interventions in the PoCUS plus CT group suggests that PoCUS may help identify patients who would benefit most from CT, potentially leading to more efficient use of resources. Reference: Orosco, J. A., et al. (2024). Point-of-care ultrasound associated with shorter length of stay than computed tomography for renal colic. *Emergency Medicine*, 66(5), 538-543.
The following is a summary of “Point-of-care ultrasound associated with shorter length of stay than computed tomography for renal colic,” published in the May 2024 issue of Emergency medicine by Orosco, et al.
Although computed tomography (CT) and point-of-care ultrasound (PoCUS) effectively diagnose renal colic, CT is more resource-intensive. For one study, researchers sought to compare the length of stay (LOS) of patients with renal colic in the emergency department based on the imaging modality used. Additionally, they compared infection rates, repeat ED visits, missed significant pathology, and urologic intervention.
The retrospective cohort study spanned 12 months (1/1/22–12/31/22) at multiple sites and included all patients diagnosed with renal colic presenting to the emergency department on days when at least one patient had a billable renal PoCUS examination. Patients with specific medical histories or incomplete examinations were excluded. Median ED LOS was compared using a Wilcoxon rank sum test, and secondary outcomes were compared using a Fisher’s exact test.
Of the 415 patients screened, 325 were included: 150 had CT alone, 80 had PoCUS alone, 54 had PoCUS plus CT, and 41 had neither. The median LOS for PoCUS alone was 75.0 (95% CI 39.3–110.7) minutes shorter than for CT alone (231.5 vs. 307.0 minutes, P < 0.0001). Infection rates, return visits, and missed pathologies were similar across groups (P > 0.10). Urological interventions were higher in the PoCUS plus CT group (25.9%) compared to CT alone (7.3%), PoCUS alone (2.5%) and neither (7.3%). P < 0.0001.
In patients with renal colic, PoCUS was associated with a shorter ED LOS than CT, with no differences in infection rates, revisits, or missed pathology. The higher rate of urological interventions in the PoCUS plus CT group suggests that PoCUS may help identify patients who would benefit most from CT.
Reference: sciencedirect.com/science/article/abs/pii/S0735675724000846
