Assessment of emergency department urolithiasis presentations during the COVID-19 pandemic

ABSTRACT

Introduction & Objective: During the unprecedented COVID- 19 pandemic, there have been major changes in healthcare delivery, patients seeking care and access to care. We sought to determine if there were differences in Emergency Department (ED) presentations for urolithiasis and their triage from the ED. Methods: We assessed the all ED presentations and those for urolithiasis (defined as codes N20.0 and N20.1) from January 2019 through December 2020 at four hospitals (one primary, two secondary and one tertiary/quaternary care) in a single hospital network in the Indianapolis metro area. We also assessed the patient's disposition, either discharged from the ED or admitted to the hospital. Results: There were 109,656 total ED presentations in 2019 and 1369 ED presentations for urolithiasis (12.5%). In 2020, there were 94143 total ED presentations with 1212 for urolithiasis (12.9%). There was no significant difference between total stone presentation between the 2019 and 2020. In 2020, there were significant increases in the rate of stone presentations in May (1.39% vs 0.010%, p = 0.02) and August (1.64% vs 1.13%, p = 0.0035). There was a significant decrease in the rate of stone presentation in December 2020 compared to December 2019 (0.91% vs 1.34%, p = 0.0096). Figure 1 demonstrates the monthly ED Visits for urolithiasis compared between 2019 and 2020, with the monthly COVID-19 cases in Indiana. There was a decline in total visits 71.5% of visits were dismissed from the ED in 2019 compared to 70.2% in 2020. There were no differences in the rates of ED discharge or hospital admission on a monthly basis between 2019 and 2020. Conclusions: Within a hospital system in the Indianapolis metropolitan area, there does not appear to be a change in ED stone presentations or disposition patterns between 2019 and 2020 despite the COVID-19 pandemic. (Table Presented).