Hospitalización en paciente con cólico renal: Caracterización clínico-epidemiológica en el Hospital Clínico Herminda Martín, período marzo 2014 - marzo 2019 / Hospitalization in a patient with renal colic: Clinical-epidemiological characterization at the Herminda Martín Clinical Hospital, period March 2014 - March 2019

INTRODUCCIÓN: El cólico renal es una condición médica común en los servicios de urgencia. Representa la manifestación clínica más frecuente de urolitiasis, cuya patogenia es multifactorial, con tasas de prevalencia varía de 1% a 20% y una recurrencia a 10 años del 42% al 50%. OBJETIVO: Establecer el perfil clínico-epidemiológico, como también el diagnóstico y manejo de los pacientes hospitalizados por cólico renal en el Hospital Clínico Herminda Martín (HCHCM). MATERIAL Y MÉTODO: Estudio descriptivo retrospectivo en pacientes hospitalizados con diagnóstico de cólico renal en el HCHM de Chillán en el período marzo 2014-marzo 2019. Se estudiaron las variables: sexo, edad, presentación clínica de ingreso, factores de riesgo asociados, motivo de hospitalización, resultados imagenológicos y manejo clínico. Resultados. El 52,45% correspondió a pacientes de sexo masculino, encontrándose la mayor cantidad de pacientes en el intervalo de 40-49 años. La obesidad, antecedente de urolitiasis e hipertensión arterial fueron las patologías asociadas más frecuentes. En la mayoría de los pacientes, el motivo de la hospitalización fue la refractariedad al tratamiento analgésico, alcanzando un 86,76%. El 56,37% de los pacientes recibió manejo médico expulsivo y a un 19,11% de los pacientes se le realizó una intervención quirúrgica durante la hospitalización. CONCLUSIÓN: El perfil de éstos pacientes no sólo permite establecer medidas que podrían evitar un evento litiásico, sino que además se demuestra la necesidad de realizar un manejo óptimo que puede evitar reconsultas, sobrecarga de los servicios de urgencia, aumento de días cama y complicaciones.

INTRODUCTION: Renal colic is a common condition in the emergency department. It represents the most frequent clinical manifestation of urolithiasis, whose prevalence rate varies between 1% to 20%. Its pathogenesis is multifactorial, with a recurrence of 10 years from 42-50%. OBJECTIVE: Establish the clinical-epidemiological profile, as well as the diagnosis and management of patients hospitalized for renal colic at the Herminda Martín Clinical Hospital(HCHM). MATERIALS AND METHODS: A retrospective descriptive study of hospitalized patients diagnosed with renal colic at the HCHM, March 2014-March 2019, the variables were studied: sex, age, the clinical presentation of admission, associated risk factors, the reason for hospitalization, imaging results, and management. Results: 52.45% were male patients, with the highest number of patients in the range of 40-49 years. Obesity, a history of urolithiasis and hypertension, occurred more frequently within the associated pathologies. In most patients, refractable to analgesic treatment was the reason for hospitalization, reaching 86.76%. 56.37% of patients received expulsion medical management, and 19.11% of patientshad surgeryduring hospitalization. CONCLUSION: The profile of these patients not only allows them to establish measures that could prevent a lithiasis event but also shows the need for effective management of patients who can avoid reconsults, an overload of emergency services, increasedbed days and complications

Renal colic at emergency departments. Epidemiologic, diagnostic and etiopathogenic study.

OBJECTIVES: To investigate epidemiologic, etiopathogenic and clinical factors associated with emergency renal colic (RC). METHODS ANDS RESULTS: We performed a prospective cross-sectional multicenter case-control study of 146 patients treated for RC at emergency departments. Data collected included age, sex, localization/severity of pain, symptoms, personal/family medical history, urine analysis, etiopathogenic factors, chemical composition of the lithiasis, and x-ray studies. Comparative statistical analysis was performed using SPSS 12.2 software. RC was more frequent in men; maximum incidence was between 31-50 years for both sex, with 36.3% in men and 21.23% in women; 60.27% of patients rated pain as severe; 140 RC patients (95.89%) had urologic antecedents vs. 15 (10.27%) controls without RC (p<0.001). The most frequent presentation (93.83%) was sudden intense lumbar-abdominal or lumbar pain; 23.28% of RC patients had family history for urinary lithiasis vs. 6.16% controls (p<0,001). Most RC patients were seen during summer (36.58%), 82% of RC patients drank <2L of water daily vs. 18.49% in non-RC patients (p<0.001). Hematuria was found in 132 (90.41%) patients with RC vs. 17 (11.64%) in those without (p<0.001). Lithiasis was observed by KUB x-ray in 42.10% of RC patients vs. 57.89% controls, most frequent calculi composition was calcium oxalate monohydrate and dehydrate (61,2%). CONCLUSIONS: The incidence of urinary lithiasis and RC in our health care area shows a male predominance. The characteristic pain of RC is severe and appears suddenly. It starts in the back (lumbar region), below the ribs, radiating towards the groin and external genitals (testicles in man or major lips in woman) on the same side. Nausea and vomiting are frequent. Family history of urinary lithiasis and low water intake are risk factors that need to be investigated. Occupations associated with a sedentary life style or with a hot, dry workplace show a higher incidence of lithiasis. A hot, dry climate favours the formation of urinary lithiasis and the highest incidence of lithiasis is in the summer, during the months of July and August. The most frequent component of urolithiasis in our study, as well as in other studies, was calcium oxalate monohydrate and dihydrate.