Yale Tung Chen1, Pablo Rodríguez Fuertes2, Paloma Oliver Sáez3, Tomás Villén Villegas4, Antonio Buño Soto3, Pilar Fernández Calle3, César Carballo Cardona5, Julio Cobo Mora2, Milagros Jaén Cañadas2, Hoi Yan Tong6, Alberto M Borobia6. 1. Servicio de Urgencias, Hospital Universitario La Paz, Madrid, España. Departmento de Medicina, Universidad Alfonso X El Sabio, Madrid, España. 2. Servicio de Urgencias, Hospital Universitario La Paz, Madrid, España. 3. Servicio de Análisis Clínicos, Hospital Universitario La Paz, Madrid, España. 4. Facultad de Medicina, Universidad Francisco de Vitoria, Madrid, España. 5. Servicio de Urgencias, Hospital Universitario Ramón y Cajal, Madrid, España. 6. Unidad Central de Investigación Clínica y Ensayos Clínicos (UCICEC), Servicio de Farmacología Clínica, Hospital Universitario La Paz, Madrid, España. IdiPAZ.
Abstract
OBJECTIVES: To evaluate a fast-track pathway utilizing point-of-care (POC) testing and sonography as soon as uncomplicated renal or ureteral colic is suspected and to compare the POC clinical pathway to a standard one. MATERIAL AND METHODS: Unblinded randomized controlled clinical trial in a hospital emergency department (ED). We enrolled patients with suspected uncomplicated renal or ureteral colic and randomized them to a POC or standard pathway (1:1 ratio). Duration of ED stay, treatments, the proportion of diagnoses other than uncomplicated colic, and 30-day complications were analyzed. RESULTS:One hundred forty patients were recruited between November 2018 and October 2019; data for 124 were analyzed. The mean (SD) total time in the ED was 112 (45) minutes in the POC arm and 244 (102) in the standard arm (P .001). Treatments, alternative diagnoses, and complication rates did not differ. CONCLUSION: The use of a fast-track POC pathway to manage uncomplicated colic in the ED is effective and safe. It also reduces the amount of time spent in the ED.
RCT Entities:
OBJECTIVES: To evaluate a fast-track pathway utilizing point-of-care (POC) testing and sonography as soon as uncomplicated renal or ureteral colic is suspected and to compare the POC clinical pathway to a standard one. MATERIAL AND METHODS: Unblinded randomized controlled clinical trial in a hospital emergency department (ED). We enrolled patients with suspected uncomplicated renal or ureteral colic and randomized them to a POC or standard pathway (1:1 ratio). Duration of ED stay, treatments, the proportion of diagnoses other than uncomplicated colic, and 30-day complications were analyzed. RESULTS: One hundred forty patients were recruited between November 2018 and October 2019; data for 124 were analyzed. The mean (SD) total time in the ED was 112 (45) minutes in the POC arm and 244 (102) in the standard arm (P .001). Treatments, alternative diagnoses, and complication rates did not differ. CONCLUSION: The use of a fast-track POC pathway to manage uncomplicated colic in the ED is effective and safe. It also reduces the amount of time spent in the ED.
Entities:
Keywords:
Colic, renal or ureteral.; Cólico renoureteral; Ecografía en el punto de atención; Point-of-care testing.; Point-of-care ultrasound.; Pruebas de laboratorio en el punto de atención.