Evidence map›Paper›PMID 38219263›Full record

ArticleCJEM2024

Renal point-of-care ultrasound performed by ED staff with limited training and 30-day outcomes in patients with renal colic.

W F Lee, S J Goh, Berlin Lee, S J Juan, Marxengel Asinas-Tan, B L Lim

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Article in CJEM, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

W F LeeEmergency Department, Ng Teng Fong General Hospital, 1, Jurong East Street 21, Singapore, 609606, Singapore. Wei_Feng_Lee@nuhs.edu.sg.ORCID 0000-0001-9720-818X
S J GohEmergency Department, Ng Teng Fong General Hospital, 1, Jurong East Street 21, Singapore, 609606, Singapore.
Berlin LeeEmergency Department, Ng Teng Fong General Hospital, 1, Jurong East Street 21, Singapore, 609606, Singapore.
S J JuanEmergency Department, Ng Teng Fong General Hospital, 1, Jurong East Street 21, Singapore, 609606, Singapore.
Marxengel Asinas-TanEmergency Department, Ng Teng Fong General Hospital, 1, Jurong East Street 21, Singapore, 609606, Singapore.
B L LimEmergency Department, Ng Teng Fong General Hospital, 1, Jurong East Street 21, Singapore, 609606, Singapore.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimEmergency Department (ED) renal point-of-care ultrasound (PoCUS) in renal colic by accredited specialists has good prognostic value. This may not be generalizable to under-resourced EDs. We investigated PoCUS in renal colic in our ED with lesser training.

methodsWe performed a single-centre health records review of adult ED patients with renal colic and PoCUS. Patients were managed by a non-ED specialist/resident doctor with no POCUS accreditation in consultation with an attending. These doctors attended a 3.5-h training session conducted by accredited attendings to examine hydronephrosis. They needed to verify their PoCUS findings with an attending during the first two weeks of their six-month posting before performing it independently. The primary outcome was 30-day urological procedures in hydronephrotic vs. non-hydronephrotic groups. Secondary outcomes were the distribution of primary outcome with grades of hydronephrosis, 30-day ED nephrolithiasis-related reattendances in hydronephrotic vs. non-hydronephrotic groups and its distribution with grades of hydronephrosis. We compared outcomes using Fisher's exact test. We also reported crude odds ratio (COR) and 95% CI of primary outcome between hydronephrotic vs. non-hydronephrotic groups. p values ≤ 0.05 were significant.

resultsWe recruited 651 patients; 160 (24.6%) without and 491 (75.4%) with hydronephrosis. Rates of grades of hydronephrosis were: mild (76.6%), moderate (13.8%), severe (1.2%) and undifferentiated (8.4%). There was a difference in 30-day urological procedures (rates [95% CI]) in hydronephrotic vs. non-hydronephrotic groups, 11.2 [8.7-14.0]% vs. 2.5 [1.0-6.3]%; p < 0.001; COR (95% CI) 4.9 (1.8-13.8); p = 0.002. Increasing 30-day urological procedural rates were associated with increasing grade of hydronephrosis [no: 2.5%, mild: 7.7%, moderate: 23.5%, severe: 67.0% and undifferentiated: 14.6%; p < 0.001]. No differences occurred in other secondary outcomes.

conclusionsRenal PoCUS could be performed by non-ED specialist/resident doctors to identify patients without hydronephrosis who rarely required urological intervention. Hydronephrotic patients could benefit from further risk stratification.

Indexed as

HydronephrosisRenal ColicAdultEmergency Service, HospitalHumansPoint-of-Care SystemsTomography, X-Ray ComputedUltrasonographyHydronephrosisPoint-of-careRenal colicRenal ultrasonography

Identifiers

PMID38219263

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.