Patients presenting to emergency departments with renal colic due to symptomatic kidney stones benefit from early intervention (EI), investigators reported at the American Urological Association’s 2023 annual meeting in Chicago.
Limited data exist regarding the optimal timing for intervention in these cases, according to a team led by Michael Ordon, MD, MSc, of the University of Toronto in Canada.
In a population-based cohort study conducted in Ontario, Canada, Dr Ordon and colleagues analyzed 397,185 index renal colic events in patients who presented to emergency departments. A total of 28,910 patients received EI, defined as shockwave lithotripsy, ureteroscopy, or percutaneous nephrolithotomy within 2 weeks of presentation. The remaining 368,275 patients had delayed intervention/expectant management (the non-EI group).
Compared with the non-EI group, the EI group had a significant 30% lower risk for additional emergency department visits and 48% lower risk for hospital admission, Dr Ordon reported in a poster presentation.
The EI group also had a significant 38% and 51% lower risk for stent or nephrostomy insertion, respectively.
The EI group, however, had a significant 2% increased risk for a urology or primary care visit. In the non-EI group, 17% of patients eventually received an intervention. The groups did not differ significantly with respect to additional imaging.
“These findings could influence practice patterns and guideline recommendations moving forward,” the author noted.
Ordon M, Bota S, Kang Y, Welk B. The impact of timing of definitive intervention for patients with acute renal colic: A population-based study. Presented at: AUA 2023, April 28-May 1, Chicago. Abstract MP16-03.