Email updates

Keep up to date with the latest news and content from BMC Nephrology and BioMed Central.

Open Access Research article

Geriatric urolithiasis in the emergency department: risk factors for hospitalisation and emergency management patterns of acute urolithiasis

Spyridon Arampatzis12*, Gregor Lindner2, Filiz Irmak2, Georg-Christian Funk3, Heinz Zimmermann2 and Aristomenis K Exadaktylos2

Author Affiliations

1 Department of Nephrology and Hypertension, Inselspital, University of Bern, Bern, Switzerland

2 Department of Emergency Medicine, Inselspital, University of Bern, Bern, Switzerland

3 Department of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for Chronic Obstructive Pulmonary Disease, Otto Wagner Hospital, Vienna, Austria

For all author emails, please log on.

BMC Nephrology 2012, 13:117  doi:10.1186/1471-2369-13-117

Published: 24 September 2012

Abstract

Background

Urolithiasis is one of the most common conditions seen in emergency departments (ED) worldwide, with an increasing frequency in geriatric patients (>65 years). Given the high costs of emergency medical urolithiasis treatment, the need to optimise management is obvious. We aimed to determine risk factors for hospitalisation and evaluate diagnostic and emergency treatment patterns by ED physicians in geriatric urolithiasis patients to assist in optimising treatment.

Methods

After receiving ethics committee approval, we examined the records of emergency urolithiasis admissions to our ED between January 2000 and December 2010 to determine risk factors for hospitalisation and to evaluate current diagnostic and emergency treatment patterns in geriatric urolithiasis patients.

Results

1,267 consecutive patients at least 20 years of age with confirmed urolithiasis (1,361 ED visits) and complete follow-up data were analyzed. Geriatric patients comprised 10% of urolithiasis patients with more than half of them experiencing their first urolithiasis episode at ED admission. Although stone site, side and size did not significantly differ between groups, urinary stone disease was more severe in the elderly. The risk of severe complications correlated with increasing age, female sex and diabetes mellitus. Geriatric patients had a two-fold greater likelihood of being hospitalised. A significantly lower percentage of geriatric patients received combined analgesic therapy for pain management (37% vs. 64%, p = <0.001) and supportive expulsive treatment (9% vs. 24%, p = <0.001).

Conclusion

Geriatric patients with urolithiasis have a higher morbidity than younger patients and may be undertreated concerning analgetic and expulsive treatment in ED.

Keywords:
Urolithiasis; Geriatric patients; Emergency department; Hospitalisation