Clinical and Radiological Predictors of Early Intervention in Acute Ureteral Colic
| Autor: | Sa’ed H. Zyoud, Abdoh Abdallah, Francis X. Keeley, Mohammad Alkarajeh, Mosab Maree, Mahfouz Ktaifan, Faris Abushamma, Amir Aghbar, Ahmed Awadghanem, Ahmad Jaradat |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Ureteric Stone
medicine.medical_specialty ureteral calculi business.industry Urology International Journal of General Medicine Retrospective cohort study spontaneous stone passage General Medicine Emergency department medicine.disease medicine.anatomical_structure pyonephrosis maximal length of ureteral calculi Radiological weapon Cohort medicine medical expulsive therapy Pyonephrosis business Renal pelvis Pelvis Original Research |
| Zdroj: | International Journal of General Medicine |
| ISSN: | 1178-7074 |
| Popis: | Faris Abushamma,1,2 Mahfouz Ktaifan,1 Abdoh Abdallah,1 Mohammad Alkarajeh,1 Mosab Maree,1,3 Ahmed Awadghanem,1,3 Ahmad Jaradat,1,2 Amir Aghbar,1,2 Saâed H Zyoud,4,5 Francis X Keeley Jr6 1Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine; 2Department of Urology, An-Najah National University Hospital, Nablus, 44839, Palestine; 3Department of Radiology, An-Najah National University Hospital, Nablus, 44839, Palestine; 4Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine; 5Clinical Research Center, An-Najah National University Hospital, Nablus, 44839, Palestine; 6Bristol Urological Institute, North Bristol NHS Trust, Bristol, UKCorrespondence: Faris AbushammaDepartment of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, PalestineEmail farisabushamma@hotmail.comPurpose: Acute ureteric colic (AUC) is generally one of the most common reasons for emergency department attendance. Expectant management is recommended in non-complicated ureteral calculi. However, data regarding the optimal duration of observation or indications of early intervention (EI) are not well understood. This article describes the clinical and radiological factors that promote EI in AUC.Patients and Methods: This was an observational and retrospective cohort study. Patients with AUC diagnosed based on non-contrast computerized tomography (NCCT) between 2019 and 2020 were enrolled in the study. These patients were classified into two main categories: spontaneous passage of stone (SSP) and EI. In addition, a comparative analysis was performed to identify clinical and radiological variables that promote EI.Results: One-hundred and sixty-one patients were included. High WBCs are associated with a significant increase in EI. Forty-three percent (n=37) of patients with serum WBCs higher than 10 had an EI, while 23% had SSP (n=17;p< 0.001). High CRP level is also significantly associated with EI (n=36; 86%; p< 0.001). Upper and middle ureteral calculi are statistically associated with EI (n=54; 62%) in comparison to the SSP cohort (n=22; 30%;p< 0.001). EI is also linked to the maximal length of ureteric calculi (MCL) of 9 mm (6â 13mm), and HU density of stone of 700 (430â 990) H.U (p< 0.001). Ureteric stone volume of 0.2 (0.06â 0.3) cm3 is significantly associated with EI (p< 0.001). Ureteral wall thickness of 3 (2â 3 mm), the presence of extrarenal pelvis (n=20; 23%), and AP diameter of renal pelvis 18 (13â 28 mm) are all significantly associated with a higher rate of EI (p< 0.001). Multiple binary logistic regression analysis showed that MCL is the strongest predictor of EI.Conclusion: MCL is an independent and robust predictor of EI in AUC. Biochemical variables and radiological characteristics can also act as an adjunct to promote EI.Keywords: ureteral calculi, medical expulsive therapy, spontaneous stone passage, maximal length of ureteral calculi, pyonephrosis |
| Databáze: | OpenAIRE |
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