Rendimiento del uroanálisis en pacientes con sospecha diagnóstica de cólico renoureteral en el servicio de urgencias

Abstract

Introduction Ureterolithiasis is a highly frequent pathology. Due to the association of hematuria with the presence of urolithiasis, the low cost and high availability of uroanalysis, its performance was evaluated for the diagnosis of urolithiasis . Methodology Cross-sectional study of diagnostic test. Adult patients who entered consecutively with a diagnostic impression of urolithiasis from July 2017 to December 2017 were included, UroTAC was defined as gold standard. The diagnostic performance of uroanalysis was determined calculating the operative characteristics of hematuria and the presence of crystals. Results 466 patients were evaluated, the median age was 45 years (RIQ: 36-55 years). 257 patients (55.1%) presented a history of urolithiasis. Urolithiasis was confirmed in 340 patients (73.0%) by UroTAC. In 314 cases (67.4%) hematuria occurred. The sensitivity and specificity of hematuria are 75.9% and 55.6% respectively. The VPP and VPN are 82.2% and 46.1% respectively. The presence of crystals has a sensitivity of 10% and specificity or 93.7%, PPV and NPV of 81.0% and 27.8% respectively. The simultaneous presence of hematuria and crystals did not improve the test performance Conclusion Although it is plausible that uroanalysis can serve as diagnostic support for the clinical suspicion of ureterolithiasis, this study shows that the presence of hematuria and cylindruria, have a very low yield and therefore, its use should be reassessed in a population with clinical symptoms of renoureteral colic.