Most patients with renal colic are discharged from the emergency department (ED) after evaluation and pain alleviation. These patients may not require urgent imaging by computed tomography. We derived a clinical prediction score in patients with renal colic to identify those at very low risk for complications and alternative diagnoses requiring urgent intervention. This retrospective chart review was carried out in 2 ED at an urban university hospital from January to December 2015. All patients with a diagnosis of renal colic were included. The primary outcome was an intervention required for renal colic or alternative diagnoses within 7 days of ED presentation. A stepwise logistic regression was used to assess factors associated with the outcome. A score was derived as a weighted sum of these predictors and its performance was calculated. The database was submitted to the French National Commission for Data Protection and Liberties (CNIL): declaration n°2164898v0 (03/22/2018). 871 with complete data were analyzed. In 94 (11%) patients, an intervention was performed for obstructive urolithiasis or alternative diagnosis. Five factors were most predictive of intervention: age > 45 years (1 point), a history of urologic surgery (1 point), pulse > 100 bpm (1 point), temperature > 37.8 °C (2 point), and urine dipstick negative for blood (1 point), yielding a score of 0-6 points (the Complicated uroLithiasis and Alternative Diagnosis (CLAD) score). The area under the curve of the receiver operating characteristic curve was 0.82 (95% CI 0.77-0.87). We derived a clinical score for renal colic that predicted the presence of obstructive urolithiasis and acute alternative diagnoses requiring intervention.

中文翻译：

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梗阻性尿石症的临床预测规则的推导以及需要紧急干预的替代诊断：CLAD评分。

经过评估和缓解疼痛后，大多数肾绞痛患者都从急诊科（ED）出院。这些患者可能不需要通过计算机断层摄影术进行紧急成像。我们得出了肾绞痛患者的临床预测评分，以识别出并发症风险极低且需要紧急干预的其他诊断。这项回顾性图表审查于2015年1月至12月在城市大学医院的2 ED中进行。纳入了所有诊断为肾绞痛的患者。主要结局是在出现ED后7天内进行肾绞痛或其他诊断所需的干预措施。使用逐步逻辑回归来评估与结果相关的因素。得分是这些预测变量的加权总和，并计算了其绩效。该数据库已提交给法国国家数据保护和自由委员会（CNIL）：公告编号2164898v0（03/22/2018）。分析了具有完整数据的871。在94名（11％）患者中，进行了阻塞性尿路结石或其他诊断的干预。五个因素是干预的最有预测性的因素：年龄> 45岁（1分），泌尿外科手术史（1分），脉搏> 100 bpm（1分），温度> 37.8°C（2分）和尿液试纸阴性血液（1分），得分为0-6分（复杂的尿路结石病和替代诊断（CLAD）得分）。接收器工作特性曲线的曲线下面积为0.82（95％CI 0.77-0.87）。