Rise in emergency department visits of pediatric patients for renal colic from 1999 to 2008

Abstract

Objective: Renal colic has been considered predominantly a disease of adults with only occasional cases occurring in the pediatric population. A recent report from a single hospital showed a rise in the number of children with renal colic. Our objective was to examine this in a much larger multihospital database of emergency department (ED) visits.

Methods: This study has a retrospective cohort design. It was conducted on consecutive pediatric patients (age <18 years) with a diagnosis of "renal colic, calculus kidney, calculus ureter, urinary calculus, or urethral calculus" according to the International Classification of Diseases, Ninth Revision, as seen by ED physicians in 29 urban, suburban, and rural EDs in New Jersey and New York between January 1, 1999, and December 31, 2008. We analyzed the number of renal colic visits as a percent of total ED pediatric visits in yearly intervals using the Student t test and performed a regression analysis. The α was set at 0.05.

Results: The database contained 6,497,458 total ED visits, of which 1,312,487 (20%) were pediatric visits. Of these, 1005 (0.077%) were for renal colic. The median age of these pediatric patients was 16 years (interquartile range, 13-17 years) and 61% were female. The percentage of ED pediatric visits for renal colic increased from 0.048% in 1999 to 0.089% in 2008, an increase of 86% (95% confidence interval, 36%-154%; P < 0.001). The correlation coefficient for this upward trend was R2 = 0.69 (P = 0.003).

Conclusions: We found a marked increase in ED pediatric visits for renal colic over the past decade. This may reflect a real increase in the incidence of renal colic in the pediatric population or an increased use of imaging modalities for abdominal and flank pain.