Presented by: Amit Shemesh MD
Samson Assuta Ashdod University Hospital

Introduction

Urolithiasis is one of the most common urology related admissions in the Emergency Department (ED). However, only a small proportion necessitate hospital admission or urologic intervention. Our objective is to identify and describe the factors that can predict the need for hospital admission or urologic intervention.

Materials

A retrospective analysis was conducted on all patients admitted to the ED and found to have a ureteric stone on CT. Clinical, laboratory, and imaging parameters were collected, along with data regarding admissions, surgical procedures. Need for urology intervention and admission was assessed with relation to patients presenting parameters in the ED.

 

Results

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Between January 2018 and January 2020, an abdominal CT-proven ureteric stone was found in 805 patients during an ED visit in a single institution. Of those, 773 patients met the inclusion criteria. A total of 304 (39%) were admitted to the hospital of them 210 (69%) underwent surgical procedure. Of 469 discharged patients 86 (18%) required surgical intervention.

Parameters associated with hospitalization were older age, stone size, stone location, inflammatory markers, creatinine level, fever, positive urine culture, personal history of urolithiasis

Parameters associated with surgical intervention were older age, female gender, stone size, stone location, presence of renal stone, creatinine level, inflammatory markers, fever, positive urine culture and history of prior procedure

Conclusion

The majority of hospitalized ureteral stone patients require intervention with overlapping in the associated factors for surgical intervention and admission. Older age, infectious status and stone parameters are significant factors for intervention and admission, with personal history of urolithiasis associated with admission and female gender and prior surgery associated with surgical intervention.

 

Funding

None

Co-Authors

Dor Golomb, MD
Samson Assuta Ashdod University Hospital

Hanan Goldberg, MD, MSc
SUNY Upstate Medical University

Eyal Hen, MD
Samson Assuta Ashdod University Hospital

Fahed Atamna, MD
Samson Assuta Ashdod University Hospital

Amir Cooper, MD
Samson Assuta Ashdod University Hospital

Orit Raz, MD
Samson Assuta Ashdod University Hospital