Andrew Worster1, Ted Haines. 1. Division of Emergency Medicine, Hamilton Health Sciences Corporation, Faculty of Health Sciences, McMaster University, Health Sciences Centre, Hamilton, Ont. aworster@hhsc.ca
Abstract
OBJECTIVE: To determine if replacing intravenous pyelography with noncontrast helical computed tomography (NHCT) scanning of the abdomen for the investigation of suspected acute urolithiasis results in shorter stays in the Emergency Department, reduced hospital admissions or fewer interventions. METHODS: A retrospective review of the charts of all patients who were discharged from the Emergency Department with a diagnosis of acute urolithiasis or renal colic was conducted. Length of stay, hospital admissions and the number of therapeutic interventions were compared for the 5-month period before and the 5-month period after the implementation of NHCT scanning of the abdomen as the primary investigation of suspected acute urolithiasis. RESULTS:Of 230 cases reviewed, 119 met all of the inclusion criteria (61 in the intravenous pyelography group and 58 in the NHCT group). No significant differences were found between the 2 groups on median length of stay in the Emergency Department (7.6 h v. 6.2 h), hospital admission rates or post-test therapeutic interventions. CONCLUSIONS: Replacing intravenous pyelography with NHCT scanning for the investigation of suspected acute urolithiasis does not result in significantly shorter stays, reduced hospital admissions or fewer interventions for patients.
RCT Entities:
OBJECTIVE: To determine if replacing intravenous pyelography with noncontrast helical computed tomography (NHCT) scanning of the abdomen for the investigation of suspected acute urolithiasis results in shorter stays in the Emergency Department, reduced hospital admissions or fewer interventions. METHODS: A retrospective review of the charts of all patients who were discharged from the Emergency Department with a diagnosis of acute urolithiasis or renal colic was conducted. Length of stay, hospital admissions and the number of therapeutic interventions were compared for the 5-month period before and the 5-month period after the implementation of NHCT scanning of the abdomen as the primary investigation of suspected acute urolithiasis. RESULTS: Of 230 cases reviewed, 119 met all of the inclusion criteria (61 in the intravenous pyelography group and 58 in the NHCT group). No significant differences were found between the 2 groups on median length of stay in the Emergency Department (7.6 h v. 6.2 h), hospital admission rates or post-test therapeutic interventions. CONCLUSIONS: Replacing intravenous pyelography with NHCT scanning for the investigation of suspected acute urolithiasis does not result in significantly shorter stays, reduced hospital admissions or fewer interventions for patients.
Authors: David Atkins; Dana Best; Peter A Briss; Martin Eccles; Yngve Falck-Ytter; Signe Flottorp; Gordon H Guyatt; Robin T Harbour; Margaret C Haugh; David Henry; Suzanne Hill; Roman Jaeschke; Gillian Leng; Alessandro Liberati; Nicola Magrini; James Mason; Philippa Middleton; Jacek Mrukowicz; Dianne O'Connell; Andrew D Oxman; Bob Phillips; Holger J Schünemann; Tessa Tan-Torres Edejer; Helena Varonen; Gunn E Vist; John W Williams; Stephanie Zaza Journal: BMJ Date: 2004-06-19
Authors: Holger J Schünemann; A Holger J Schünemann; Andrew D Oxman; Jan Brozek; Paul Glasziou; Roman Jaeschke; Gunn E Vist; John W Williams; Regina Kunz; Jonathan Craig; Victor M Montori; Patrick Bossuyt; Gordon H Guyatt Journal: BMJ Date: 2008-05-17