Table 3.
Predictors of urologic intervention at 90 days for patients with CT-confirmed ureteral stone with and without CT findings.
| Unadjusted Estimates (n=475) | Adjusted Estimates with CT findings (n=445) | Adjusted Estimates without CT results (n=445) | ||||||
|---|---|---|---|---|---|---|---|---|
| Predictors of Urologic Intervention | OR (95% CI) | p-value | OR (95% CI) | p-value | OR (95% CI) | p-value | ||
| History of urologic procedure | 7.4 (4.4 – 12) | <0.001 | 5.7 (2.8 – 11) | <0.001 | *** | 7.5 (4.2 – 14) | <0.001 | *** |
| Pain duration >=6 hours on presentation | 2.6 (1.6 – 4) | <0.001 | 1.9 (1 – 3.5) | 0.042 | *** | 2.1 (1.3 – 3.7) | 0.005 | *** |
| Hemodynamic instability | 3.2 (1.4 – 7.1) | 0.006 | 2.6 (0.7 – 8.9) | 0.13 | 2.5 (0.9 – 7) | 0.076 | ||
| CVA tenderness to palpation on exam | 1.8 (1.2 – 2.8) | 0.005 | 2.6 (1.4 – 5.1) | 0.002 | *** | 1.8 (1.1 – 3.1) | 0.026 | *** |
| Subjective fever or chills | 1.7 (1 – 3) | 0.067 | 1.4 (0.8 – 2.5) | 0.28 | 1.5 (0.9 – 2.5) | 0.142 | ||
| Evidence of UTI | 2.5 (1.5 – 4.2) | <0.001 | 0.9 (0.4 – 2) | 0.86 | 1.1 (0.6 – 2.1) | 0.81 | ||
| Serum WBC > 11 × 109/L | 1.4 (0.9 – 2.1) | 0.154 | 1 (0.6 – 1.8) | 0.92 | 1 (0.6 – 1.6) | 0.896 | ||
| Serum creatinine > 1.5 mg/dL | 3.2 (1.4 – 7.1) | 0.006 | 2.5 (0.8 – 7.3) | 0.11 | 2.3 (0.9 – 5.9) | 0.07 | ||
| Moderate or greater hydronephrosis on CT | 1.8 (1.2 – 2.9) | 0.01 | 0.9 (0.5 – 1.8) | 0.85 | -- | -- | ||
| Large stone (>5mm) on CT | 15 (8.7 – 25) | <0.001 | 12 (6.3 – 25) | <0.001 | *** | -- | -- | |
| Proximal stone location on CT (mid-ureter or above) | 3.9 (2.6 – 5.9) | <0.001 | 2 (1.1 – 3.7) | 0.019 | *** | -- | -- | |
| Moderate or greater hydronephrosis on renal PLUS | 1.9(1.3 – 3) | 0.003 | 1.7 (0.9 – 3.1) | 0.101 | 2.1 (1.2 – 3.6) | 0.006 | *** | |
| Antibiotics given in the ED | 3.9 (2.4 – 6.4) | <0.001 | 2.2 (1.1 – 4.4) | 0.025 | *** | 2.7 (1.5 – 5.1) | 0.002 | *** |
| Opiates given in the ED | 1.4 (0.9 – 2.2) | 0.21 | 2 (1 – 4.1) | 0.043 | *** | 1.4 (0.8 – 2.6) | 0.235 | *** |
|
| ||||||||
| Model AUC | 0.887 | 0.804 | ||||||
***
Indicates statistically significant predictors in multivariable analysis.
*
Patients were considered to have evidence of UTI if leukocyte esterase and/or 6 or more WBCs were present on urinalysis.
AUC: area under the curve (c-statistic), OR: odds ratio, CI: confidence interval, CVA: costovertebral angle, ED: emergency department, hpf: high-powered field, WBC: white blood cell, CT: computed tomography scan, PLUS: renal point-of-care limited ultrasound, UA