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Emergency department (<jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>) studies have suggested differences in access to care, diagnostic imaging use, pain management, and intervention. We investigated sex\u2010based differences in the care and outcomes for <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content> patients with acute renal colic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a multicenter population\u2010based retrospective observational cohort study using administrative data and supplemented by structured chart review. All patients seen in Calgary Health Region <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>s between January 1 and December 31, 2014, with an <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content> diagnosis of renal colic based on the following <jats:styled-content style=\"fixed-case\">ICD<\/jats:styled-content>\u201010 codes were eligible for inclusion: calculus of kidney (N200), calculus of ureter (N201), calculus of kidney with calculus of ureter (N202), hydronephrosis with renal and ureteral calculous obstruction (N132), unspecified renal colic (N23), and unspecified urinary calculus (N209). <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content> visit data and test results were accessed in the regional <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content> clinical database. Stone characteristics were captured from diagnostic imaging reports. Regional hospital databases were used to identify subsequent <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content> encounters, hospital admissions, and surgical procedures within 60\u00a0days. Outcomes were stratified by sex. The primary outcome, intended as a marker of overall effectiveness of <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content> care, was the unscheduled 7\u2010day <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content> revisit rate among patients who were discharged home after their index <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content> visit. Secondary outcomes included <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content> pain management as reflected by administration of narcotics or intravenous nonsteroidals, the performance of advanced imaging\u2014either ultrasound (<jats:styled-content style=\"fixed-case\">US<\/jats:styled-content>) or computed tomography (<jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>), and the proportion of patients who required hospitalization or surgical intervention within 60\u00a0days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From January 1 to December 31, 2014, a total of 3,104 eligible patients were studied: 1,111 women (35.8%) and 1,993 men (64.2%). Baseline characteristics, access times, analgesic use, and admission rates were similar in both groups. Men were more likely to have <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> (68.9% vs. 58.5%, difference\u00a0=\u00a010.4%, 95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>]\u00a0=\u00a06.8 to 14.0) while women were more likely to have <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content> (20.8% vs. 9.6%, difference\u00a0=\u00a011.2%, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a08.4 to 13.9). At 7\u00a0days, 17.9% of women and 19.0% of men who were discharged after their index <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content> visit required an <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content> revisit (difference\u00a0=\u00a01.1%, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a0\u22122.8 to 4.9). Men were more likely to be hospitalized at 7\u00a0days (9.8% vs. 6.5%, difference\u00a0=\u00a03.3%, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a00.6 to 6.0).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study shows greater reliance on <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content> in females but no other sex\u2010specific differences in the management of <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content> patients with acute renal colic. Higher <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> use in men was not associated with improved outcomes, and we found no important differences in access to care, diagnostic or treatment intensity, or revisit rates as a marker of care effectiveness.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.13041","type":"journal-article","created":{"date-parts":[[2016,6,30]],"date-time":"2016-06-30T05:34:07Z","timestamp":1467264847000},"page":"1153-1160","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Sex\u2010related Differences in Emergency Department Renal Colic Management: Females Have Fewer Computed Tomography Scans but Similar Outcomes"],"prefix":"10.1111","volume":"23","author":[{"given":"Grant D.","family":"Innes","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine Cumming School of Medicine University of Calgary Calgary Alberta Canada"},{"name":"Department of Community 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