371 A Single-Centre Impact Assessment of Delayed Imaging in Suspected Ureteric Colic

Abstract

Abstract Introduction Ureteric colic accounts for a quarter of emergency Urology presentations (Talreja et al, 2015). The British Association of Urological Surgeons (BAUS) recommends a CT of the urinary tract within 14 hours of presentation. However, District General Hospitals frequently lack access to cross-sectional imaging overnight for the purpose of investigating suspected ureteric colic. With the ever-increasing pressure on bed spaces, we report on the delay in discharge of appropriate patients with suspected ureteric colic due to delayed access to imaging. Method We performed a retrospective review of admissions for ureteric colic from October 2021 to March 2022. We determined the time from presentaon to performance of CT. Assessment of suitability for discharge was based on the BAUS consensus document. Factors contributing to delayed discharge were determined through case note review. Results and Conclusions Of 140 patients included, almost half (47%) were admitted overnight. 64% of admissions were avoidable by adherence to the BAUS guidelines on safe discharge. 54 patients were not discharged the same day: 57% due to delay in obtaining CT imaging, 17% due to sepsis, 13% due to AKI, and 13% due to reasons not specified. The mean discharge delay due to imaging was 1 day (0-3). Notably, only 60% of referrals with suspected ureteric colic had a ureteric stone present. We therefore conclude that imaging at the point of presentation of suspected ureteric colic can prevent unnecessary admission and direct safe patient discharge. These results have led to local introduction of a patient pathway to improve management.