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Predictive values of haematuria and hydronephrosis in suspected renal colic: An emergency department retrospective audit
Author(s) -
Saw Jarel TS,
Imeri Nerissa Nexhmije,
Aldridge Emogene S,
Buntine Paul G
Publication year - 2020
Publication title -
emergency medicine australasia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.602
H-Index - 52
eISSN - 1742-6723
pISSN - 1742-6731
DOI - 10.1111/1742-6723.13462
Subject(s) - medicine , hydronephrosis , renal colic , emergency department , predictive value , retrospective cohort study , radiology , urology , surgery , urinary system , pathology , alternative medicine , psychiatry
Objective To determine the predictive values of haematuria and hydronephrosis in suspected renal colic. Methods We undertook a retrospective audit of adult patients who received a computed tomography (CT) of the kidneys, ureter and bladder (CTKUB) for suspected renal colic, presenting to Eastern Health Emergency Departments in Melbourne, Australia, between 1 January 2016 and 30 June 2016. CT hydronephrosis was used as a substitute for ultrasound hydronephrosis. We looked at the association of haematuria and CT proven hydronephrosis with CT proven ureteric and obstructing pelvic calculi. Results Of 769 adult cases who received a CTKUB for suspected renal colic, 384 were positive (49.9%) and 385 were negative (50.1%). For haematuria and renal colic, sensitivity was 87.3% (83.3–90.7), specificity 33.8% (28.9–39.0), positive predictive value (PPV) 55.7% (53.7–57.8), negative predictive value (NPV) 73.6% (67.1–79.3). For CT hydronephrosis and renal colic, sensitivity was 88.0% (84.2–91.1), specificity 85.0% (80.9–88.5), PPV 85.7% (82.4–88.5), NPV 87.4% (84.0–90.2). Of 110 cases with both negative CT hydronephrosis and negative haematuria, four had ureteric calculi, NPV 96.4% (90.8–98.6). Conclusion This audit suggests that a diagnostic strategy relying on the absence of haematuria or hydronephrosis, or both, to rule out ureteric calculi may result in a small number of stones being missed.