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Master Thesis

Facteurs prédictifs et élaboration d’un outil de dépistage de l’insuffisance rénale dans la colique néphrétique aux urgences adultes de Pellegrin

Abstract : Introduction: renal colic is an extremely common pathology in an increasingly saturated emergency department. The recommendations require the completion of a biological assessment with a creatinine test without a high level of evidence. We believe that it is possible, for a part of the population, to avoid carrying out this biological assessment, which is a source of considerable waiting time in emergencies. Objectives: the primary objective of our study is to highlight predictive factors of acute renal failure in renal colic in order to develop a score to better detect these patients. Methods: our retrospective observational study studied a cohort of 542 patients diagnosed with renal colic in adult Pellegrin emergencies from May 1st to December 31st, 2016. Univariate and multivariate analyzes were performed for the study of predictors of occurrence. renal insufficiency in renal colic, then selection of step-by-step variables. For the construction of the score, the weight of each of the variables was defined on the basis of the values of the beta coefficients (β) resulting from these analyzes. The diagnostic capacity of each of the scores was modeled using a ROC curve. Results: the three variables with influence allowed the development of the following score: age> 40 years +1, pain duration> 24h +1, PAS> 150mmHg +1. Total: 3 points. Discussion: we were able to highlight three factors predicting renal failure (age> 40 years, pain duration> 24 h, PAS> 150 mmHg), and thus create a screening tool allowing, on this cohort, the eviction of 30 % of biological assessments of nephritic colic. The advantage of this screening tool is the saving of time caused by the eviction of the biological assessment and the financial gain from a public health point of view. It should be tested on a larger prospective cohort. Conclusion: this study highlights the existence of three predictive factors of acute renal failure in renal colic. The screening tool, derived from these risk factors, allows the eviction of a biological assessment in 30% of patients in this cohort. Given the frequency of this diagnosis in emergencies, it seems interesting to continue the evaluation of this score in a prospective study of greater power to validate the utility.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01844799
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Submitted on : Thursday, July 19, 2018 - 4:53:31 PM
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Brice Etcheverry. Facteurs prédictifs et élaboration d’un outil de dépistage de l’insuffisance rénale dans la colique néphrétique aux urgences adultes de Pellegrin. Médecine humaine et pathologie. 2018. ⟨dumas-01844799⟩

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