• Emergencias · Feb 2021

    Randomized Controlled Trial

    Efficacy of a fast-track pathway for managing uncomplicated renal or ureteral colic in a hospital emergency department: the STONE randomized clinical trial of Sonography and Testing of a Nephrolithiasis Episode.

    • Yale Tung Chen, Pablo Rodríguez Fuertes, Paloma Oliver Sáez, Tomás Villén Villegas, Antonio Buño Soto, Pilar Fernández Calle, César Carballo Cardona, Julio Cobo Mora, Milagros Jaén Cañadas, Hoi Yan Tong, and M BorobiaAlbertoAUnidad Central de Investigación Clínica y Ensayos Clínicos (UCICEC), Servicio de Farmacología Clínica, Hospital Universitario La Paz, Madrid, España. IdiPAZ..
    • Servicio de Urgencias, Hospital Universitario La Paz, Madrid, España. Departmento de Medicina, Universidad Alfonso X El Sabio, Madrid, España.
    • Emergencias. 2021 Feb 1; 33 (1): 23-28.

    ObjectivesTo evaluate a fast-track pathway utilizing point-of-care (POC) testing and sonography as soon as uncomplicated renal or ureteral colic is suspected and to compare the POC clinical pathway to a standard one.Material And MethodsUnblinded randomized controlled clinical trial in a hospital emergency department (ED). We enrolled patients with suspected uncomplicated renal or ureteral colic and randomized them to a POC or standard pathway (1:1 ratio). Duration of ED stay, treatments, the proportion of diagnoses other than uncomplicated colic, and 30-day complications were analyzed.ResultsOne hundred forty patients were recruited between November 2018 and October 2019; data for 124 were analyzed. The mean (SD) total time in the ED was 112 (45) minutes in the POC arm and 244 (102) in the standard arm (P .001). Treatments, alternative diagnoses, and complication rates did not differ.ConclusionThe use of a fast-track POC pathway to manage uncomplicated colic in the ED is effective and safe. It also reduces the amount of time spent in the ED.

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