Repeated hospital emergency department visits for nephritic colic

Bauset Navarro JL, Cinesi Gómez C, Izquierdo Barnés R, Pérez López MV, Rosillo Castro D, González Valverde FM

Objective: To describe the characteristics of patients seeking retreatment for renal or

ureteral colic within 72 hours of a first visit to the emergency department.

Material and methods: Descriptive single center epidemiologic study based on records for

patients with nephritic colic treated in the emergency department of Hospital General Reina

Sofía in Murcia, Spain, in 2009. Data for patients who were readmitted to the emergency

department were compared with data for patients who did not return. We studied

demographic variables, history of emergency visits, diagnostic workup, and treatment.

Results: A total of 1386 emergency department visits for nephritic colic by 1256

patients were studied; 1150 (91.56%) patients came to the emergency department

once and 106 (8.44%) sought emergency care at least twice (236 visits). Men revisited

more frequently than women (odds ratio [OR], 3.14; 95% confidence interval [CI],

1.92-5.17; P<.001). As well as those patients with a history of urinary tract stones, 57.54% came more than once to the emergency room (OR, 1.89; 95% CI, 1.24-2.89; P=.0017). Plain radiographs were ordered during 756 (65.7%) first visits and 57 (53.8%) subsequent visits (OR, 0.61; 95% CI, 0.40-0.93; P<.001). Abdominal sonograms were done on the first visits of 155 (13.4%) patients and on 29 (27.45%) subsequent visits (OR, 2.18, 95% CI, 1.5-3.16; P<.001). Analgesics prescribed included dexketoprofen (OR, 1.44, 95% CI, 105.1-96; P=.016). On subsequent visits to the emergency department tramadol (OR, 1.75; 95% CI, 1.05-2.88; P=.002) and benzodiazepines (OR, 2.01; 95% CI, 1.32-3.07; P<.001) were prescribed more often. Conclusions: The number of emergency department visits for nephritic colic is high; most patients are men with a history of colic. Ultrasonography is used mainly for patients with persistent pain. Dexketoprofen alleviated pain. In the prescription of analgesics, it was clear that levels of severity were being considered. Tramadol as an analgesic and benzodiazepines as adjuvant medication were efficacious.

Bauset Navarro JL, Cinesi Gómez C, González Valverde FM, Izquierdo Barnés R, Pérez López MV, Rosillo Castro D