The outcome of computed tomography in patients with acute renal colic from a low-volume hospital

Abstract

Objective: To assess the interobserver variability of unenhanced helical computed tomography (UHCT) in patients with acute renal colic admitted into a low-volume hospital.

Materials and methods: All admissions with acute renal colic between August 2002 and February 2004 (18 months) were registered. A total of 133 CT scans were performed on patients suspected of having a stone in the urinary tract (< 24 h after admission). All records were subsequently evaluated, the acute CT scans were re-evaluated by a radiological specialist. Interobserver agreements were assessed by means of Kappa analysis.

Results: A total of 133 consecutive patients met the criteria for inclusion, of whom 62 were women and 71 were men. A total of 67 stones in 53 patients were identified. The variability of the radiological diagnosis (doctors under training and one consultant) was calculated, and the Kappa values were +0.66 and +0.69 for stones on the right and left side, respectively. The Kappa values for stones in ureter and the kidney were +0.79 and +0.52, respectively. In addition to stone disease, there were additional diagnoses in 30 patients (23%), out of whom seven had a malignant tumor.

Conclusion: In a low-volume hospital with fewer than 100 procedures a year, we found the UHCT method to be safe and reliable with a good interobserver agreement and Kappa value.