MP51-01 SIXTY-DAY OUTCOMES AFTER SURGICAL VS. MEDICAL TREATMENT OF ACUTE RENAL COLIC

Abstract

You have accessJournal of UrologyStone Disease: Surgical Therapy V1 Apr 2016MP51-01 SIXTY-DAY OUTCOMES AFTER SURGICAL VS. MEDICAL TREATMENT OF ACUTE RENAL COLIC Taylor Remondini, Samir Sami, Bryce Weber, Dean Wong, Anthony Cook, and Grant Innes Taylor RemondiniTaylor Remondini More articles by this author , Samir SamiSamir Sami More articles by this author , Bryce WeberBryce Weber More articles by this author , Dean WongDean Wong More articles by this author , Anthony CookAnthony Cook More articles by this author , and Grant InnesGrant Innes More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.456AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Renal colic is a common condition, affecting up to 10% of the population. Recent research suggests that medical expulsive therapy may be less effective in successful passage rates. Therefore we wish to evaluate a large cohort of renal colic patients in a high intervention setting to determine their characteristics and health care burden. METHODS This multicenter administrative database study retrospectively reviewed the all Calgary patients with an ED diagnosis of renal colic between Jan 1, 2014 and Dec 31, 2014. Demographics were captured from the regional ED database, tests and treatments from the order entry database, and ED revisits, admissions and interventions from the discharge abstract database. RESULTS 3104 renal colic visits were studied at 4 hospitals, including 921 (30%) with an index surgical intervention and 2183 (70%) managed medically. 1850 (54%) had confirmed ureteric stones and of these 752 (41%) had surgery at index visit with an additional 137 (8%) having surgery with in 60 days. Patients were more likely to have surgery if had a proximal ureteric stone (P<0.001, OR 2.2), stone larger than 5 mm (P<0.001, OR 4.4), or hydronephrosis (p<0.001, OR 2.3). Within 60 days surgical patients had higher need for readmission (p<0.001, OR 2.2) and emergency visits (p<0.001, OR 1.8). The presence of a proximal stone at index visit was the main risk factor for surgical patients requiring further ED visits, and readmission (p<0.001, OR 1.2). Medically managed patients had a trend toward more surgical procedures (p=0.06, OR 0.74) in the following sixty days and the main risk factor being the presence of a proximal stone (p<0.001, OR 2.9) at index visit. CONCLUSIONS Patients who undergo early surgical intervention for acute renal colic have more hospital visits and less surgical procedures in the following 60-days than medically treated patients; however, outcome differences are driven by stone location. Stone size and the presence of hydronephrosis were deciding factors in need for surgery yet did not lead to more ED visits, admissions or procedures post index visit. Yet proximal stones not only were more likely to have index surgery but also had more ED visits, and admissions post initial procedure. Similarly if a proximal stone is managed medically it is also more likely to require a procedure with in 60 days possibly just delaying the issues with surgery in this cohort. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e681 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Taylor Remondini More articles by this author Samir Sami More articles by this author Bryce Weber More articles by this author Dean Wong More articles by this author Anthony Cook More articles by this author Grant Innes More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...