Abstract：
Emergency department (ED) clinicians may misdiagnose renal infarction (RI) as urolithiasis because RI is a rare disease with presenting symptoms similar to the symptoms of urolithiasis. However, earlier diagnosis of RI can improve patient prognosis.
We investigated potential predictors for distinguishing RI from urolithiasis based on clinical findings and laboratory results.
This randomly matched retrospective case-control study included patients who had been diagnosed with acute RI or acute urolithiasis between January 2016 and March 2020. Patients were excluded if they were aged under 18 years, had a history of trauma, or had incomplete medical records. Using a matching ratio of 1:4, RI patients were randomly matched to urolithiasis patients. Multivariable logistic regression was performed to identify factors that could distinguish RI from urolithiasis.
In total, 48 patients were included in the RI group and 192 patients were included in the urolithiasis group. Multivariable logistic regression showed that age ≥ 65 years (odds ratio [OR] 6.155; p = 0.022), atrial fibrillation (OR 18.472; p = 0.045), current smoking (OR 17.070; p = 0.001), costovertebral angle tenderness (OR 0.179; p = 0.037), aspartate aminotransferase level ≥ 27.5 U/L (OR 6.932; p = 0.009), sodium level ≥ 138.5 mEq/L (OR 0.079; p = 0.004), and hematuria (OR 0.042; p = 0.001) were significant predictors that could distinguish RI from urolithiasis. Based on these results, a nomogram was constructed.
Age ≥ 65 years, atrial fibrillation, current smoking, absence of costovertebral angle tenderness, aspartate aminotransferase level ≥ 27.5 U/L, sodium level < 138.5 mEq/L, and absence of hematuria were predictors that can distinguish between RI and urolithiasis.
We investigated potential predictors for distinguishing RI from urolithiasis based on clinical findings and laboratory results.
This randomly matched retrospective case-control study included patients who had been diagnosed with acute RI or acute urolithiasis between January 2016 and March 2020. Patients were excluded if they were aged under 18 years, had a history of trauma, or had incomplete medical records. Using a matching ratio of 1:4, RI patients were randomly matched to urolithiasis patients. Multivariable logistic regression was performed to identify factors that could distinguish RI from urolithiasis.
In total, 48 patients were included in the RI group and 192 patients were included in the urolithiasis group. Multivariable logistic regression showed that age ≥ 65 years (odds ratio [OR] 6.155; p = 0.022), atrial fibrillation (OR 18.472; p = 0.045), current smoking (OR 17.070; p = 0.001), costovertebral angle tenderness (OR 0.179; p = 0.037), aspartate aminotransferase level ≥ 27.5 U/L (OR 6.932; p = 0.009), sodium level ≥ 138.5 mEq/L (OR 0.079; p = 0.004), and hematuria (OR 0.042; p = 0.001) were significant predictors that could distinguish RI from urolithiasis. Based on these results, a nomogram was constructed.
Age ≥ 65 years, atrial fibrillation, current smoking, absence of costovertebral angle tenderness, aspartate aminotransferase level ≥ 27.5 U/L, sodium level < 138.5 mEq/L, and absence of hematuria were predictors that can distinguish between RI and urolithiasis.
摘要：
背景：急诊科（ED）临床医生可能将肾梗塞（RI）误诊为尿石症，因为RI是一种罕见的疾病，其症状与尿石症症状相似。然而,早期诊断RI可改善患者预后。
目的：我们根据临床发现和实验室结果研究了鉴别RI和尿石症的潜在预测因子。
方法：这项随机匹配的回顾性病例对照研究纳入了2016年1月至2020年3月被诊断为急性RI或急性尿路结石的患者。如果患者年龄在18岁以下，则将其排除在外。有外伤史,或者病历不完整.使用1：4的匹配比例，将RI患者与尿石症患者随机匹配。进行多变量逻辑回归以确定可以区分RI和尿石症的因素。
结果：总计，RI组48例，尿石症组192例。多变量logistic回归显示年龄≥65岁(比值比[OR]6.155;p=0.022),心房颤动（OR18.472；p=0.045），当前吸烟（OR17.070；p=0.001），脊柱角压痛（OR0.179；p=0.037），谷草转氨酶水平≥27.5U/L（OR6.932；p=0.009），钠水平≥138.5mEq/L（OR0.079；p=0.004），和血尿（OR0.042;p=0.001）是可以区分RI和尿石症的重要预测因子。基于这些结果,构造了一个列线图。
结论：年龄≥65岁，心房颤动,目前吸烟,没有脊柱角压痛，谷草转氨酶水平≥27.5U/L,钠含量<138.5mEq/L，和没有血尿是可以区分RI和尿石症的预测因子。
目的：我们根据临床发现和实验室结果研究了鉴别RI和尿石症的潜在预测因子。
方法：这项随机匹配的回顾性病例对照研究纳入了2016年1月至2020年3月被诊断为急性RI或急性尿路结石的患者。如果患者年龄在18岁以下，则将其排除在外。有外伤史,或者病历不完整.使用1：4的匹配比例，将RI患者与尿石症患者随机匹配。进行多变量逻辑回归以确定可以区分RI和尿石症的因素。
结果：总计，RI组48例，尿石症组192例。多变量logistic回归显示年龄≥65岁(比值比[OR]6.155;p=0.022),心房颤动（OR18.472；p=0.045），当前吸烟（OR17.070；p=0.001），脊柱角压痛（OR0.179；p=0.037），谷草转氨酶水平≥27.5U/L（OR6.932；p=0.009），钠水平≥138.5mEq/L（OR0.079；p=0.004），和血尿（OR0.042;p=0.001）是可以区分RI和尿石症的重要预测因子。基于这些结果,构造了一个列线图。
结论：年龄≥65岁，心房颤动,目前吸烟,没有脊柱角压痛，谷草转氨酶水平≥27.5U/L,钠含量<138.5mEq/L，和没有血尿是可以区分RI和尿石症的预测因子。
