Diagnostic and treatment patterns for renal colic in US emergency departments

To describe the epidemiology, imaging and treatment patterns of acute renal colic in US emergency departments.

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.

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.

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.