Introduction / Aim and Objective
To provide a “snapshot” of practice for patients requiring emergency CTKUB and summarise stone-related outcomes over one year following their presentation.
Patients and Methods
Patients were identified by radiology records as undergoing emergency CTKUB in eight specialist stone units in June 2015. 363 patients had confirmed urolithiasis from the 732 patients analysed (49.6%).
Results
Patients with stones were significantly more likely to be male, have hydronephrosis, previous stone history (all p=0.001) and non-visible haematuria (p=0.02) than non-stone patients. 158 stones were distal ureteric (43.5%) and 61 were proximal ureteric (16.8%).
A summary of intervention / stone sizes, and outcomes for stone, tube and readmission status during follow-up are shown in tables 1 and 2. Nearly 80% of patients were initially managed conservatively, 40% were recorded to have had MET, 14% required in-patient intervention (emergency drainage accounting for 10.7%) and 1.4% had acute URS to achieve stone clearance
Discussion / Conclusion
A stone detection rate of approximately 50% is typical across the literature for patients with symptoms suggestive of acute ureteric colic. This study has shown that patients with increasing stone size have greater likelihood of retaining tubing at 6 weeks, six months and one year. More than 10% of patients were readmitted at 6 weeks and six months (again with increased risk with larger stones). These data should help inform the baseline standards for “what good looks like” for the current management of patients who present as an emergency with urolithiasis in the UK.