Emergency Department Ultrasound in Renal Colic

Completed

• Conditions: Abdominal Aortic Aneurysm; Hydronephrosis; Renal Colic
• Interventions: Procedure: EDTU

• Registration Number: NCT01323842
• Lead Sponsor: Queen's University

Brief Summary

Renal colic is a common (1300 visits per year at our institution) and painful condition caused by stones in the kidney and ureter, and can be mimicked by life threatening conditions such as a ruptured abdominal aortic aneurysm (AAA). This can create clinical uncertainty. Emergency department targeted ultrasound (EDTU) is performed by an emergency physician at the patient's bedside, and has been shown to be accurate, safe, and efficient. We have shown that EDTU can accurately identify hydronephrosis, which is a predictor of complications of kidney stones. A normal formal ultrasound (US) predicts an uncomplicated clinical course. We will assess the accuracy of EDTU for the diagnosis of hydronephrosis, and when normal, whether patients can be safely discharged.

Detailed Description

Not available

Study Timeline

• Study Start: 2011-03
• Study First Submitted: 2011-03-24
• Study First Submitted QC: 2011-03-24
• Study First Posted: 2011-03-28
• Primary Completion: 2013-07
• Study Completion: 2013-12
• Status Verified: 2015-11
• Last Update Submitted: 2015-11-24
• Last Update Posted: 2015-11-26

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 414

Inclusion Criteria

• Age 16 - 65 years
• Symptoms suggestive of renal colic
• EDTU performed within one hour (before or after) of formal imaging
• Imaging study arranged during this ED visit (includes next morning)

Exclusion Criteria

• Hemodynamic instability (Pulse > 120 or SBP < 90 or requiring vasopressors)
• Fever (>38 degrees C)
• Leukocytes and nitrites on dipstick urinalysis (evidence of urinary tract infection)
• Pregnancy
• Inmate
• Renal transplant or single functioning kidney

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
rule in renal colic	EDTU	ED patients with abdominal/flank pain where a diagnosis of renal colic is being considered and undergoing formal imaging while in the ED

Primary Outcome Measures

Name	Time	Method
diagnostic accuracy for hydronephrosis	1 hours	The accuracy of ED physicians in using EDTU to assess for hydronephrosis when compared to diagnostic imaging by CT or formal ultrasound.
complications post-ED visit in patients with and without negative EDTU.	30 days	The frequency of complications by 30 days post-ED visit in patients with and without negative EDTU.

Secondary Outcome Measures

Name	Time	Method
ED length of stay	1 day	estimates of potential time of ED stay saved if a clinical decision is made on the basis of an EDTU (rather than waiting for formal diagnostic imaging)
radiation dose	1 hour	potential savings in radiation exposure from avoiding CT scanning
accuracy in ruling out AAA	1 hour	accuracy of ED physicians in using EDTU to assess aortic size (and rule out AAA) when compared to diagnostic imaging by CT or formal ultrasound will also be validated.

Trial Locations

Locations (1)

Kingston General Hospital; 🇨🇦 Kingston, Ontario, Canada