Does replacing intravenous pyelography with noncontrast helical computed tomography benefit patients with suspected acute urolithiasis?
OBJECTIVE
To determine if replacing intravenous pyelography with noncontrast helical computed tomography (NHCT) scanning of the abdomen for the investigation of suspected acute urolithiasis results in shorter stays in the Emergency Department, reduced hospital admissions or fewer interventions.


METHODS
A retrospective review of the charts of all patients who were discharged from the Emergency Department with a diagnosis of acute urolithiasis or renal colic was conducted. Length of stay, hospital admissions and the number of therapeutic interventions were compared for the 5-month period before and the 5-month period after the implementation of NHCT scanning of the abdomen as the primary investigation of suspected acute urolithiasis.


RESULTS
Of 230 cases reviewed, 119 met all of the inclusion criteria (61 in the intravenous pyelography group and 58 in the NHCT group). No significant differences were found between the 2 groups on median length of stay in the Emergency Department (7.6 h v. 6.2 h), hospital admission rates or post-test therapeutic interventions.


CONCLUSIONS
Replacing intravenous pyelography with NHCT scanning for the investigation of suspected acute urolithiasis does not result in significantly shorter stays, reduced hospital admissions or fewer interventions for patients.
Worster
Andrew
A
Division of Emergency Medicine, Hamilton Health Sciences Corporation, Faculty of Health Sciences, McMaster University, Health Sciences Centre, Hamilton, Ont. aworster@hhsc.ca
Haines
Ted
T
D000208:Acute Disease; D005260:Female; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014545:Urinary Calculi / Q000000981:diagnostic imaging*; D014567:Urography