Emergency Department Ultrasound in Renal Colic
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.
|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.
|Study Start Date:||March 2011|
|Estimated Study Completion Date:||December 2013|
|Estimated Primary Completion Date:||September 2013 (Final data collection date for primary outcome measure)|
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
bedside ultrasound imaging by the treating emergency physician
|Kingston General Hospital|
|Kingston, Ontario, Canada, K7L 2V7|
|Principal Investigator:||Eric Bruder, MD||Queen's University|