Renal and ureteric stones are responsible for 12,000 hospital admissions each year, but many patients do not require admission to hospital and do not require intervention.

Low contrast CT KUB reported within 24 hours has been the National Institute for Health and Care Excellence (NICE) gold standard investigation for patients presenting with renal colic.

Royal Liverpool University Hospital set up an ‘adult renal colic’ pathway where patients presenting with features of renal colic are offered a low dose CT KUB with a Consultant Radiologist report within 24 hours.

Out-of-hours renal colic patients (weekdays 1700 – 0800 and over weekends) that are not acutely unwell have their CTKUB accepted by a radiographer, the images are reviewed by the clinician and are reported the following morning by a Consultant Radiologist. The unwell patients or...

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This audit was a retrospective study that looked at all patients:

• Greater than 16 years of age
• Presented to A&E (Accident and Emergency) and ESAU (Emergency Surgical Assessment Unit) from February 2022 to March 2022
• Fit the renal colic pathway criteria

The data was collecting using:

• CRIS (CDN Radiology Information System) for imaging request
• PACS (Picture Archiving and Communication System) for imaging report
• PENS (Patient Electronic NoteS) for clinical history

This audit looked at 97 patients, 44 F vs 53 M with an average age of 44.5 years old.

39% of scans were requested ‘in hours’ and 72 % scans were requested during weekdays.

98% scan were reported in 24 hours and 2% (n=2) scans were reported after 24 hours (Image 1). 5% of the scans were escalated to the on call radiology service.

55% of scans were positive for renal or ureteric stones (Image 2). 35 scans where positive for ureteric calculi (Graph 1). 32% of scans had obstruction secondary to calculus.

69% (40/58) scans performed out-of-hours had abnormalities reported (Table 1). 22 scans performed out of hours (38%) had a provisional report noted on PENS by the ordering clinician. 82% (18/22) matched the...

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In conclusion, Royal Liverpool hospital is 98% compliant with NICE standard. Furthermore, the ‘adult renal colic’ pathway is the key reason why our trust compliance is this high.

The trust will carry on preserving this pathway with some further actions to improve which patient requires a scan and to improve the compliance of the clinicians to assess the scan prior the report.