Diagnostic and treatment patterns for renal colic in US emergency departments

Purpose: To describe the epidemiology, imaging and treatment patterns of acute renal colic in US emergency departments. Materials and methods: Data on 25,622 visits representing 108 million emergency department visits were obtained from the 2000 National Hospital Ambulatory Medical Care Survey. Demographic and clinical information are presented descriptively. Results: There were a total of 259 records representing 1,139,257 visits with a primary ED diagnosis of renal calculus or colic. The majority of patients are young males, presenting with moderate to severe flank pain. Patients received an average of two medications from a pharmacopoeia of several dozen. The most commonly used medications were ketorolac. promthiazine and morphine. Antibiotics were prescribed in over 20% of cases. Just under half of all patients had a radiographic test, and a similar number had one or more blood tests. Fewer than 10% were admitted. Conclusions: Renal colic is a common emergency department presentation and but there is widespread variation in the type of ancillary testing obtained. Patients may not obtain those radiological tests required to ensure prompt urological follow-up. Further work should be aimed at developing protocols for the emergent management of patients with renal colic.