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Do Emergency Department Observation Units Help Prevent Revisits for Patients with Renal Colic?
Philip Giarrusso1, Christopher Raio1, Anil Bhagavath1
1Department of Emergency Medicine, Good Samaritan University Hospital, 1000 Montauk Highway, West Islip, New York, United States of America.
The American Journal of Emergency Medicine
|December 28, 2024
Summary
Patients with renal colic discharged from the emergency department (ED) observation unit (EDOU) had similar 14-day revisit rates compared to those discharged directly home. This finding holds true even for patients with higher-risk kidney stone features in the EDOU group.
Area of Science:
- Nephrology
- Emergency Medicine
- Urology
Background:
- Renal colic is typically managed with home discharge if pain is controlled.
- Emergency department observation units (EDOU) offer an alternative disposition for renal colic patients.
- This study compares 14-day revisit rates for renal colic between EDOU and direct ED discharge.
Purpose of the Study:
- To compare 14-day emergency department (ED) revisit rates for renal colic.
- To evaluate 14-day serious ED revisits (requiring admission or urological intervention).
- To assess if ED observation units (EDOU) impact revisit rates for renal colic patients.
Main Methods:
- Retrospective observational study of adult renal colic patients (2016-2024).
- Excluded patients admitted during the index ED visit.
- Compared outcomes between direct ED discharge and EDOU disposition cohorts.
Main Results:
- 1836 patients included: 1376 (ED discharge) and 460 (EDOU).
- No significant difference in 14-day overall revisit rates (8.6% vs 9.3%).
- No significant difference in 14-day serious revisit rates (3.4% vs 3.7%).
Conclusions:
- Emergency department observation units (EDOU) did not alter 14-day revisit rates for renal colic.
- Patients in EDOU presented with higher-risk stone characteristics (larger size, proximal location, hydronephrosis).
- Despite higher-risk features, EDOU patients experienced similar revisit rates to direct discharge patients.
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