Utter Maria, Altmark Fredrik, Popiolek Marcin, Forsvall Andreas, Lundström Karl-Johan, Thiel Tomas, Wagenius Magnus
Department of Clinical Sciences, Division of Infection Medicine, Lund University, Lund Sweden; Department of Urology Helsingborg Hospital, Helsingborg, Sweden.
Department of Urology Helsingborg Hospital, Helsingborg, Sweden.
Scand J Urol. 2025 Feb 5;60:29-35. doi: 10.2340/sju.v60.42593.
The aim of this study was to evaluate the utilization and impact of emergency computed tomography (CT) on the management of renal colic, focusing on treatment decisions, time to treatment and the subsequent need for additional emergency department (ED) visits.
Retrospective analysis of patient visits to the ED in Helsingborg with a diagnosis of urolithiasis (ICD codes N20-23) between July 1, 2019 and June 30, 2020. Results: Out of 64,263 visits, 1.4% (880) visits were related to urolithiasis, involving 612 patients. Emergency CT (within 24 h) was performed in 43% of the cases, with an additional 9% undergoing CT at a subsequent emergency visit. Radiological confirmation of kidney or ureteral stone was found in 324 patients, of which 63% (204) required no treatment. Comparison between patients who underwent emergency CT and those who did not, revealed a significantly shorter time to treatment and closure in the emergency CT group. The median time to treatment was 28 days for those with an emergency CT and 59 days for those without (P < 0.001), acute surgery excluded. The median time to closure was 31 days for emergency CT compared to 37 days without emergency CT (P < 0.010), acute surgery excluded.
In this study, the use of emergency CT shortened the time to treatment and rendered the patient stone free earlier compared to deferred diagnostics, with a note of caution that emergency CT may have led to increased surgical treatments for stones that might otherwise have passed spontaneously.
gov Identifier: NCT06535711.
本研究旨在评估急诊计算机断层扫描（CT）在肾绞痛治疗中的应用及影响，重点关注治疗决策、治疗时间以及后续再次前往急诊科就诊的必要性。
对2019年7月1日至2020年6月30日期间在赫尔辛堡急诊科就诊且诊断为尿石症（国际疾病分类代码N20 - 23）的患者进行回顾性分析。结果：在64263次就诊中，1.4%（880次）与尿石症相关，涉及612名患者。43%的病例进行了急诊CT（在24小时内），另有9%的患者在后续急诊就诊时接受了CT检查。在324名患者中发现了肾脏或输尿管结石的影像学证据，其中63%（204名）无需治疗。接受急诊CT检查的患者与未接受检查的患者相比，急诊CT组的治疗时间和出院时间明显更短。排除急性手术患者后，接受急诊CT检查的患者治疗中位时间为28天，未接受检查的患者为59天（P < 0.001）。急诊CT组出院中位时间为31天，未接受急诊CT检查的患者为37天（P < 0.010），排除急性手术患者。
在本研究中，与延迟诊断相比，使用急诊CT缩短了治疗时间，使患者更早地排出结石，但需注意的是，急诊CT可能导致对原本可能自行排出的结石增加了手术治疗。
美国国立医学图书馆临床试验注册中心标识符：NCT06535711。
