Summary

Efficacy of a fast-track pathway for managing uncomplicated renal or ureteral colic in a hospital emergency department: the STONE randomized clinical trial of Sonography and Testing of a Nephrolithiasis Episode

Tung Chen Y, Rodríguez Fuertes P, Oliver Sáez P, Villén Villegas T, Buño Soto A, Fernández Calle P, Carballo Cardona C, Cobo Mora J, Jaén Cañadas M, Yan Tong H, Borobia AM

Affiliation of the authors

Servicio de Urgencias, Hospital Universitario La Paz, Madrid, Spain. Departmento de Medicina, Universidad Alfonso X El Sabio, Madrid, Spain. Servicio de Análisis Clínicos, Hospital Universitario La Paz, Madrid, Spain. Facultad de Medicina, Universidad Francisco de Vitoria, Madrid, Spain. Servicio de Urgencias, Hospital Universitario Ramón y Cajal, Madrid, Spain. Unidad Central de Investigación Clínica y Ensayos Clínicos (UCICEC), Servicio de Farmacología Clínica, Hospital Universitario La Paz, Madrid, Spain. IdiPAZ.

DOI

Quote

Tung Chen Y, Rodríguez Fuertes P, Oliver Sáez P, Villén Villegas T, Buño Soto A, Fernández Calle P, et al. Efficacy of a fast-track pathway for managing uncomplicated renal or ureteral colic in a hospital emergency department: the STONE randomized clinical trial of Sonography and Testing of a Nephrolithiasis Episode. Emergencias. 2021;33:23-8

Summary

Objectives.

To evaluate a fast-track pathway utilizing point-of-care (POC) testing and sonography as soon as uncomplicated renal or ureteral colic is suspected and to compare the POC clinical pathway to a standard one.

Methods.

Unblinded randomized controlled clinical trial in a hospital emergency department (ED). We enrolled patients with suspected uncomplicated renal or ureteral colic and randomized them to a POC or standard pathway (1:1 ratio). Duration of ED stay, treatments, the proportion of diagnoses other than uncomplicated colic, and 30-day

complications were analyzed.

Results.

One hundred forty patients were recruited between November 2018 and October 2019; data for 124 were analyzed. The mean (SD) total time in the ED was 112 (45) minutes in the POC arm and 244 (102) in the standard arm (P < .001). Treatments, alternative diagnoses, and complication rates did not differ. Conclusion. The use of a fast-track POC pathway to manage uncomplicated colic in the ED is effective and safe. It also reduces the amount of time spent in the ED.

 

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