671\u2003Improving the Basic Biochemical Evaluation of Acute Renal Colic – A Two Cycle Audit

Abstract

\n \n \n Latest guidelines by the European Association of Urology and BAUS recommend all patients presenting with acute renal colic have basic biochemical evaluation including blood calcium, urate, white cell count, CRP, sodium, potassium, and creatinine. Patients with hypercalcaemia or hyperuricaemia are particularly at risk of developing further stones, however compliance with guidelines by AE and urology departments can vary.\n \n \n \n Retrospective audit of all acute CT urinary tract (non-contrast) scans between February-April 2020 with a confirmed ureteric stone. Patients previously investigated or re-presenting were excluded. Results were shared and education on guidelines undertaken for junior clinical staff in urology followed by re-audit between May-July 2020.\n \n \n \n The first cycle February-April identified 51 patients with acute renal colic. Overall, 47% of patients had all required blood tests performed. Urate was tested in 54.9% of patients and calcium in 58.8%. Re-audit after intervention identified 50 patients. Overall compliance with blood tests increased to 62% of patients, urate tested in 66% and calcium 76%.\n \n \n \n Compliance with key screening tests for renal colic patients was generally poor in a district general hospital setting. A key causative factor identified was a lack of awareness of guidelines by junior clinicians. Education demonstrated modest improvement within a short time scale.\n