Emergency Department Ultrasound in Renal Colic
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Purpose
Renal colic is a common (1300 visits per year at our institution) and painful condition caused by stones in the kidney and ureter, and can be mimicked by life threatening conditions such as a ruptured abdominal aortic aneurysm (AAA). This can create clinical uncertainty. Emergency department targeted ultrasound (EDTU) is performed by an emergency physician at the patient's bedside, and has been shown to be accurate, safe, and efficient. We have shown that EDTU can accurately identify hydronephrosis, which is a predictor of complications of kidney stones. A normal formal ultrasound (US) predicts an uncomplicated clinical course. We will assess the accuracy of EDTU for the diagnosis of hydronephrosis, and when normal, whether patients can be safely discharged.
| Condition | Intervention |
|---|---|
|
Renal Colic Hydronephrosis Abdominal Aortic Aneurysm |
Procedure: EDTU |
| Study Type: | Observational |
| Study Design: | Observational Model: Cohort Time Perspective: Prospective |
| Official Title: | Hydro II: Emergency Department Ultrasound in Renal Colic |
- complications post-ED visit in patients with and without negative EDTU. [ Time Frame: 30 days ] [ Designated as safety issue: Yes ]The frequency of complications by 30 days post-ED visit in patients with and without negative EDTU.
- diagnostic accuracy for hydronephrosis [ Time Frame: 1 hours ] [ Designated as safety issue: No ]The accuracy of ED physicians in using EDTU to assess for hydronephrosis when compared to diagnostic imaging by CT or formal ultrasound.
- ED length of stay [ Time Frame: 1 day ] [ Designated as safety issue: No ]estimates of potential time of ED stay saved if a clinical decision is made on the basis of an EDTU (rather than waiting for formal diagnostic imaging)
- radiation dose [ Time Frame: 1 hour ] [ Designated as safety issue: Yes ]potential savings in radiation exposure from avoiding CT scanning
- accuracy in ruling out AAA [ Time Frame: 1 hour ] [ Designated as safety issue: Yes ]accuracy of ED physicians in using EDTU to assess aortic size (and rule out AAA) when compared to diagnostic imaging by CT or formal ultrasound will also be validated.
| Estimated Enrollment: | 400 |
| Study Start Date: | March 2011 |
| Estimated Study Completion Date: | December 2013 |
| Estimated Primary Completion Date: | June 2013 (Final data collection date for primary outcome measure) |
| Groups/Cohorts | Assigned Interventions |
|---|---|
|
rule in renal colic
ED patients with abdominal/flank pain where a diagnosis of renal colic is being considered and undergoing formal imaging while in the ED
|
Procedure: EDTU
bedside ultrasound imaging by the treating emergency physician
|
Eligibility| Ages Eligible for Study: | 16 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Non-Probability Sample |
ED patients with suspected renal colic being imaged while in the ED
Inclusion Criteria:
- Age 16 - 65 years
- Symptoms suggestive of renal colic
- EDTU performed within one hour (before or after) of formal imaging
- Imaging study arranged during this ED visit (includes next morning)
Exclusion Criteria:
- Hemodynamic instability (Pulse > 120 or SBP < 90 or requiring vasopressors)
- Fever (>38 degrees C)
- Leukocytes and nitrites on dipstick urinalysis (evidence of urinary tract infection)
- Pregnancy
- Inmate
- Renal transplant or single functioning kidney
Contacts and Locations| Canada, Ontario | |
| Kingston General Hospital | Recruiting |
| Kingston, Ontario, Canada, K7L 2V7 | |
| Contact: Eric Bruder, MD (613) 548-2368 brudere1@kgh.kari.net | |
| Contact: Jane Reid, RN (613) 548-2368 reidj@kgh.kari.net | |
| Principal Investigator: | Eric Bruder, MD | Queen's University |
More Information
No publications provided
| Responsible Party: | Marco L.A. Sivilotti, Research Director, Queen's University |
| ClinicalTrials.gov Identifier: | NCT01323842 History of Changes |
| Other Study ID Numbers: | Hydro II |
| Study First Received: | March 24, 2011 |
| Last Updated: | May 18, 2012 |
| Health Authority: | Canada: Health Canada |
Keywords provided by Queen's University:
|
renal colic hydronephrosis abdominal aortic aneurysm |
ultrasound emergency medicine urolithiasis |
Additional relevant MeSH terms:
|
Aneurysm Aortic Aneurysm Emergencies Hydronephrosis Renal Colic Aortic Aneurysm, Abdominal Colic Vascular Diseases Cardiovascular Diseases |
Aortic Diseases Disease Attributes Pathologic Processes Kidney Diseases Urologic Diseases Abdominal Pain Pain Signs and Symptoms Signs and Symptoms, Digestive |
ClinicalTrials.gov processed this record on May 16, 2013