Influence of primary language on follow-up after emergency department visits for acute renal colic: evidence from an ethnically diverse urban cohort.

PURPOSE: We aimed to determine whether preferred language influences follow-up for patients diagnosed with nephrolithiasis in the emergency department (ED). METHODS: We retrospectively reviewed patients referred from an ED to our clinic for symptomatic nephrolithiasis from 12/2021 to 6/2024. Patients were stratified by preferred language (English speakers [ES] vs. Non-English speakers [NES]) and compared across time to office visit, time to surgery, 24-hour urine collection, ED revisits, and failure to undergo surgery. Multivariate linear regression of log-transformed time to follow-up determined factors influencing time from ED to office visit. RESULTS: We identified 255 ES vs. 112 NES. Mandarin (44%), Cantonese (21%), and Spanish (18%) speakers comprised most of the NES cohort. NES experienced longer time to office visit (32.6 vs. 20.9 days, p < 0.001) and more ED revisits (16.1% vs. 7.8%, p = 0.02). There were no differences in time to surgery (24.8 vs. 22.3 days, p = 0.10), collection of 24-hour urine sample (22.3% vs. 17.3%, p = 0.25), or failure to undergo surgery (12.3% vs. 12.2%, p = 1.0). On multivariate regression, NES was independently associated with delayed follow-up (β = 2.49, 95% CI [1.63, 3.80], p < 0.001). On subgroup analysis, Spanish speakers had significantly longer follow-up delays than English (p < 0.001) and Chinese speakers (p = 0.003), while Chinese and English speakers did not differ (p = 0.57). CONCLUSIONS: After an ED presentation for nephrolithiasis, NES have delayed urologic follow-up and more ED revisits than ES, with subgroup analysis identifying Spanish speakers as the most affected group. Targeted interventions and language-concordant care models may reduce these disparities.