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Clinical and Radiological Predictors of Early Intervention in Acute Ureteral Colic
PURPOSE: Acute ureteric colic (AUC) is generally one of the most common reasons for emergency department attendance. Expectant management is recommended in non-complicated ureteral calculi. However, data regarding the optimal duration of observation or indications of early intervention (EI) are not...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8331218/ https://www.ncbi.nlm.nih.gov/pubmed/34354367 http://dx.doi.org/10.2147/IJGM.S322170 |
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author | Abushamma, Faris Ktaifan, Mahfouz Abdallah, Abdoh Alkarajeh, Mohammad Maree, Mosab Awadghanem, Ahmed Jaradat, Ahmad Aghbar, Amir Zyoud, Sa’ed H Keeley Jr, Francis X |
author_facet | Abushamma, Faris Ktaifan, Mahfouz Abdallah, Abdoh Alkarajeh, Mohammad Maree, Mosab Awadghanem, Ahmed Jaradat, Ahmad Aghbar, Amir Zyoud, Sa’ed H Keeley Jr, Francis X |
author_sort | Abushamma, Faris |
collection | PubMed |
description | PURPOSE: Acute ureteric colic (AUC) is generally one of the most common reasons for emergency department attendance. Expectant management is recommended in non-complicated ureteral calculi. However, data regarding the optimal duration of observation or indications of early intervention (EI) are not well understood. This article describes the clinical and radiological factors that promote EI in AUC. PATIENTS AND METHODS: This was an observational and retrospective cohort study. Patients with AUC diagnosed based on non-contrast computerized tomography (NCCT) between 2019 and 2020 were enrolled in the study. These patients were classified into two main categories: spontaneous passage of stone (SSP) and EI. In addition, a comparative analysis was performed to identify clinical and radiological variables that promote EI. RESULTS: One-hundred and sixty-one patients were included. High WBCs are associated with a significant increase in EI. Forty-three percent (n=37) of patients with serum WBCs higher than 10 had an EI, while 23% had SSP (n=17;p<0.001). High CRP level is also significantly associated with EI (n=36; 86%; p<0.001). Upper and middle ureteral calculi are statistically associated with EI (n=54; 62%) in comparison to the SSP cohort (n=22; 30%;p<0.001). EI is also linked to the maximal length of ureteric calculi (MCL) of 9 mm (6–13mm), and HU density of stone of 700 (430–990) H.U (p<0.001). Ureteric stone volume of 0.2 (0.06–0.3) cm(3) is significantly associated with EI (p<0.001). Ureteral wall thickness of 3 (2–3 mm), the presence of extrarenal pelvis (n=20; 23%), and AP diameter of renal pelvis 18 (13–28 mm) are all significantly associated with a higher rate of EI (p<0.001). Multiple binary logistic regression analysis showed that MCL is the strongest predictor of EI. CONCLUSION: MCL is an independent and robust predictor of EI in AUC. Biochemical variables and radiological characteristics can also act as an adjunct to promote EI. |
format | Online Article Text |
id | pubmed-8331218 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Dove |
record_format | MEDLINE/PubMed |
spelling | pubmed-83312182021-08-04 Clinical and Radiological Predictors of Early Intervention in Acute Ureteral Colic Abushamma, Faris Ktaifan, Mahfouz Abdallah, Abdoh Alkarajeh, Mohammad Maree, Mosab Awadghanem, Ahmed Jaradat, Ahmad Aghbar, Amir Zyoud, Sa’ed H Keeley Jr, Francis X Int J Gen Med Original Research PURPOSE: Acute ureteric colic (AUC) is generally one of the most common reasons for emergency department attendance. Expectant management is recommended in non-complicated ureteral calculi. However, data regarding the optimal duration of observation or indications of early intervention (EI) are not well understood. This article describes the clinical and radiological factors that promote EI in AUC. PATIENTS AND METHODS: This was an observational and retrospective cohort study. Patients with AUC diagnosed based on non-contrast computerized tomography (NCCT) between 2019 and 2020 were enrolled in the study. These patients were classified into two main categories: spontaneous passage of stone (SSP) and EI. In addition, a comparative analysis was performed to identify clinical and radiological variables that promote EI. RESULTS: One-hundred and sixty-one patients were included. High WBCs are associated with a significant increase in EI. Forty-three percent (n=37) of patients with serum WBCs higher than 10 had an EI, while 23% had SSP (n=17;p<0.001). High CRP level is also significantly associated with EI (n=36; 86%; p<0.001). Upper and middle ureteral calculi are statistically associated with EI (n=54; 62%) in comparison to the SSP cohort (n=22; 30%;p<0.001). EI is also linked to the maximal length of ureteric calculi (MCL) of 9 mm (6–13mm), and HU density of stone of 700 (430–990) H.U (p<0.001). Ureteric stone volume of 0.2 (0.06–0.3) cm(3) is significantly associated with EI (p<0.001). Ureteral wall thickness of 3 (2–3 mm), the presence of extrarenal pelvis (n=20; 23%), and AP diameter of renal pelvis 18 (13–28 mm) are all significantly associated with a higher rate of EI (p<0.001). Multiple binary logistic regression analysis showed that MCL is the strongest predictor of EI. CONCLUSION: MCL is an independent and robust predictor of EI in AUC. Biochemical variables and radiological characteristics can also act as an adjunct to promote EI. Dove 2021-07-30 /pmc/articles/PMC8331218/ /pubmed/34354367 http://dx.doi.org/10.2147/IJGM.S322170 Text en © 2021 Abushamma et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
spellingShingle | Original Research Abushamma, Faris Ktaifan, Mahfouz Abdallah, Abdoh Alkarajeh, Mohammad Maree, Mosab Awadghanem, Ahmed Jaradat, Ahmad Aghbar, Amir Zyoud, Sa’ed H Keeley Jr, Francis X Clinical and Radiological Predictors of Early Intervention in Acute Ureteral Colic |
title | Clinical and Radiological Predictors of Early Intervention in Acute Ureteral Colic |
title_full | Clinical and Radiological Predictors of Early Intervention in Acute Ureteral Colic |
title_fullStr | Clinical and Radiological Predictors of Early Intervention in Acute Ureteral Colic |
title_full_unstemmed | Clinical and Radiological Predictors of Early Intervention in Acute Ureteral Colic |
title_short | Clinical and Radiological Predictors of Early Intervention in Acute Ureteral Colic |
title_sort | clinical and radiological predictors of early intervention in acute ureteral colic |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8331218/ https://www.ncbi.nlm.nih.gov/pubmed/34354367 http://dx.doi.org/10.2147/IJGM.S322170 |
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