The following is a summary of “Point-of-care ultrasound associated with shorter length of stay than computed tomography for renal colic,” published in the May 2024 issue of Emergency Medicine by Orosco, et al.

While computed tomography (CT) and point-of-care ultrasound (PoCUS) effectively diagnose renal colic, CT is more resource-intensive. For a study, researchers sought to compare Emergency Department (ED) length of stay (LOS) among patients with renal colic based on the imaging modality utilized. Additionally, they compared infection rates, return ED visits, missed significant pathology, and urologic intervention.

The retrospective cohort study spanned 12 months (1/1/22–12/31/22) across multiple sites, including all patients diagnosed with renal colic who presented to the ED on days when at least one patient underwent a billable renal PoCUS examination. Patients with specific medical histories or incomplete workups were excluded. Median ED LOS was compared using a Wilcoxon rank sum test, and secondary outcomes were compared using a Fisher’s Exact test.

Among 415 screened patients, 325 were included: 150 had CT alone, 80 had PoCUS alone, 54 had PoCUS plus CT, and 41 had neither. The median LOS for PoCUS alone was 75.0 (95% CI 39.3–110.7) minutes shorter than CT alone (231.5 vs. 307.0 min, P < 0.0001). Infection rates, return visits, and missed pathology occurrence were similar across all groups (P > 0.10). Urologic interventions were higher in the PoCUS plus CT (25.9%) group compared to CT alone (7.3%), PoCUS alone (2.5%), and neither (7.3%), P < 0.0001.

Among patients with renal colic, PoCUS was associated with shorter ED LOS than CT, with no differences in infection rates, return visits, or missed pathology. The higher rate of urologic interventions in the PoCUS plus CT group suggests that PoCUS may help identify patients who would most benefit from CT.

Reference: sciencedirect.com/science/article/abs/pii/S0735675724000846