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Background and aim <p>Predicting the need for urgent urological care in Emergency Department (ED) patients with suspected renal colic remains challenging, with no validated strategy available at initial presentation. We aimed to develop a prediction model and a clinical score combining point-of-care ultrasound (POCUS) and clinical findings to identify patients at low risk of requiring urgent urological care.</p> Methods <p>We conducted a multicenter prospective study between December 2022 and June 2023 in three French EDs. Adult patients with suspected uncomplicated acute renal colic underwent POCUS examination to assess hydronephrosis severity and identify potential complications. The primary outcome was urgent urological care within 30 days, defined as inhospital admission, urological procedure within 24 h after ED admission, or new ED admission within 30 days leading to urgent urological procedure within 24 h.</p> Results <p>Among 168 patients (mean 46.1 years old, 49% female), 25 (15%) required urgent urological care within 30 days, including 8 (5%) urgent decompressions after initial ED admission and 6 (4%) following new ED admission within 30 days. Three independent predictors were identified: age over 65 years (adjusted OR, 3.7; 95% CI, 1.4–9.9), moderate to severe hydronephrosis (adjusted OR, 4.8; 95% CI, 2.1–11.8) and persistent pain 4 h after analgesic administration (adjusted OR, 12.5; 95% CI, 4.6–35). The derived ECOLIC score (range, 0–6) showed that a score ≤ 1 was associated with a 98% negative predictive value for urgent urological care.</p> Conclusion <p>The ECOLIC score combines POCUS findings (absence of moderate/severe hydronephrosis), clinical features (age &lt; 65 years), and treatment response (pain relief 4 h after analgesia) to identify patients at low risk of requiring urgent urological care at 30 days. This tool may help emergency physicians safely discharge low-risk patients without immediate CT imaging or urgent urological referral but require external validation before clinical implementation.</p>

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Point-of-care ultrasound for risk stratification of urgent urological care in acute uncomplicated renal colic

  • 期刊论文

  • 发表日期：

    2025年10月25日

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  • Bertille Griveau,
  • Mathilde Papin,
  • Chloé Thibaud,
  • Claire Mordant,
  • Christophe Berranger,
  • Emmanuel Montassier,
  • Philippe L. E. Conte,
  • Éric Batard,
  • Quentin Le Bastard

摘要

Background and aim

Predicting the need for urgent urological care in Emergency Department (ED) patients with suspected renal colic remains challenging, with no validated strategy available at initial presentation. We aimed to develop a prediction model and a clinical score combining point-of-care ultrasound (POCUS) and clinical findings to identify patients at low risk of requiring urgent urological care.

Methods

We conducted a multicenter prospective study between December 2022 and June 2023 in three French EDs. Adult patients with suspected uncomplicated acute renal colic underwent POCUS examination to assess hydronephrosis severity and identify potential complications. The primary outcome was urgent urological care within 30 days, defined as inhospital admission, urological procedure within 24 h after ED admission, or new ED admission within 30 days leading to urgent urological procedure within 24 h.

Results

Among 168 patients (mean 46.1 years old, 49% female), 25 (15%) required urgent urological care within 30 days, including 8 (5%) urgent decompressions after initial ED admission and 6 (4%) following new ED admission within 30 days. Three independent predictors were identified: age over 65 years (adjusted OR, 3.7; 95% CI, 1.4–9.9), moderate to severe hydronephrosis (adjusted OR, 4.8; 95% CI, 2.1–11.8) and persistent pain 4 h after analgesic administration (adjusted OR, 12.5; 95% CI, 4.6–35). The derived ECOLIC score (range, 0–6) showed that a score ≤ 1 was associated with a 98% negative predictive value for urgent urological care.

Conclusion

The ECOLIC score combines POCUS findings (absence of moderate/severe hydronephrosis), clinical features (age < 65 years), and treatment response (pain relief 4 h after analgesia) to identify patients at low risk of requiring urgent urological care at 30 days. This tool may help emergency physicians safely discharge low-risk patients without immediate CT imaging or urgent urological referral but require external validation before clinical implementation.