| Diagnostic Characteristics of Geriatric Patients With Ureterolithiasis in Emergency Center |
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Hyun Suk Sim, Han Sung Choi, Jong Seok Lee, Hoon Pyo Hong, Young Gwan Ko |
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Department of Emergency Medicine, Kyung Hee University School of Medicine, Seoul, Korea. hsg3748@hanmail.net |
| 응급센터에서 노인 요관결석 환자의 진단적 특징 |
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심현석⦁최한성⦁이종석⦁홍훈표⦁고영관 |
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경희대학교 의학전문대학원 응급의학교실 |
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| Abstract |
BACKGROUND
Incidence rate of ureterolithiasis has been increasing worldwide in general, with an especially rapid increase in the elderly, over 65 years of age. Therefore, the characteristics of geriatric patients diagnosed with uureterolithiasis in an Emergency Center were examined.
METHODS
A total of 613 consecutive patients who were diagnosed with ureterolithiasis through computed tomography from January 2012 to March 2014 were analyzed retrospectively. The patients were divided in two groups: the geriatric group and nongeriatric group.
RESULTS
Among the 613 patients, there were 64 geriatric patients (> or =65 years, 10.4%) and 549 nongeriatric patients (<65 years, 89.6%). In the geriatric patients, 13 patients (20.3%) appeared without any pain or with atypical types of pain, while 39 of the nongeriatric patients (7.1%) had no pain or atypical symptoms, presenting a statistically significant difference (p<0.001). Gastrointestinal symptoms such as nausea and vomiting were more common in geriatric patients than in nongeriatric patients (42.2% vs. 29.9%, p=0.044), while lower positive rate of microscopic hematuria was reported (78.1% vs. 90.5%, p=0.002). Furthermore, in geriatric patients, the positive rate of costovertebral angle tenderness was lower and distal ureter stones were found to be more common, while urine pH and serum creatinine levels were higher.
CONCLUSION
In comparison to nongeriatric patients, geriatric patients with ureterolithiasis showed lower rates of renal colic and hematuria, while showing higher rates of having gastrointestinal symptoms such as nausea and vomiting. Thus, differences between these two groups should be considered in evaluating geriatric patients to prevent complications which may be caused from the late diagnosis of ureterolithiasis. |
| Key Words:
Ureterolithiasis, Geriatrics, Emergency |
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