PREDICTORS OF URETEROLITHIASIS IN EMERGENCY DEPARTMENT PATIENTS
Author(s): T.V. Shatylko, Saratov State Medical University named after V.I. Razumovsky, Saratov , Russia, shatylko@sar-urology.ruV.M. Popkov, Dr., Prof., Saratov State Medical University named after V.I. Razumovsky, Saratov, Russia
A.Yu. Korolev, candidate of Sciences, Saratov State Medical University named after V.I. Razumovsky, Saratov, Russia
K.V. Troschanovskiy, Engels City Clinical Hospital № 1, Engels , Russia
Issue: Volume 42, № 1
Rubric: Surgery
Annotation: Differential diagnosis of renal colic due to ureterolithiasis remains an important problem in emergency medicine. Despite accurate imaging modalities, e.g. computed tomography, being available today, it is not always possible or cost-effective to rely on them in conditions of emergency department, which complicates adequate routing of the patients and delays their presentation to urological ward. Using logistic regression we have assessed the influence of various internal and external factors associated with diagnosis of ureterolithiasis. Our analysis has demonstrated that one of the most important and underappreciated external factors associated with presence of ureteral stones in patients presenting with symptoms resembling renal colic is the seasonal factor. Probability of such symptoms being caused by ureterolithiasis is increased in warm season (odds ratio [OR] = 7,5), though the explanation for this fact may be a matter of debate. Other identified predictors of ureterolithiasis were male sex (OR = 3,2), age < 60 years (OR = 2,5), gross hematuria (OR = 45,1), vomiting / nausea (OR = 2,7) and previous urolithiasis history (OR = 5,6). Although those results don’t bring anything fundamentally new in workup of urolithiasis, they rationalize routing of patients and use of special diagnostic procedures in emergency department.
Keywords: urolithiasis, ureteral stone, renal colic, differential diagnosis, seasonality
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