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Should all patients with ureteric colic be admitted?

S B Morris1, S J Hampson, E M Gordon

  • 1St George's Hospital, London.

Annals of the Royal College of Surgeons of England
|November 1, 1995
PubMed
Summary

Uncomplicated ureteric colic patients often do not require hospital admission. Direct discharge from the emergency department (A&E) is safe for many, reducing hospital stays and costs.

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Area of Science:

  • Urology
  • Emergency Medicine

Background:

  • Ureteric colic is a common cause of emergency department visits.
  • Current practice often involves admission for pain management and monitoring.

Purpose of the Study:

  • To evaluate the necessity of hospital admission for all patients presenting with uncomplicated ureteric colic.
  • To assess the safety and efficacy of a direct discharge protocol from the emergency department.

Main Methods:

  • Part 1: Assessed analgesic requirements and outcomes for 31 admitted patients with ureteric colic.
  • Part 2: Implemented a protocol for direct discharge of uncomplicated cases from the A&E department, followed by outpatient care.
  • Compared outcomes between admitted and discharged patient groups.

Main Results:

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  • 64% of admitted patients required no further analgesia post-admission; 26% needed only oral/rectal pain relief.
  • Of 58 patients managed under the new protocol, 29 were discharged directly.
  • No discharged patients required intervention for obstruction or infection; most had favorable outcomes without further acute care.

Conclusions:

  • Hospital admission is not always necessary for patients with uncomplicated ureteric colic.
  • Direct discharge from the A&E department is a safe and effective management strategy when initial pain is controlled and social support is adequate.
  • This approach can optimize resource utilization and patient flow in emergency departments.