Acute abdominal pain in the elderly

Bugliosi, Thomas F.; Meloy, Thomas D.; Vukov, Larry F.

doi:10.1016/s0196-0644(05)82602-2

Cited by 111 publications

(55 citation statements)

References 7 publications

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“…The final diagnoses of our study population differed significantly from those of previous studies, which showed a higher incidence of surgical disease and a lower incidence of infection. [20][21][22] This study also demonstrated a higher incidence of presentation related to malignancy than previously reported (7.2%, rather than 1.8%LZ3 The percentage of patients who require hospital admission has increased dramatically, compared with prior studies, which showed an admission rate of 18-27%. 24 In addition, this study showed a higher death rate than previously r e p~r t e d .~…”

Section: Discussionmentioning

confidence: 60%

Abdominal Pain in Geriatric Emergency Patients: Variables Associated with Adverse Outcomes

Marco

Schoenfeld

Keyl

et al. 1998

Academic Emergency Medicine

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Abstract. Objective: To determine the diagnoses and outcomes of geriatric patients with abdominal pain, and to identify variables associated with adverse outcomes. Methods: Geriatric emergency patients (aged 65 years and older) with a complaint of abdominal pain were participants in this longitudinal case series. Eligible patients were followed by telephone contact and chart review, to determine outcomes and final diagnoses. Results: Of 380 eligible patients, follow-up information was available for 375 (97%), for the two months following the ED visit. Final diagnoses included infection (19.2%), mechanical-obstructive disorders (15.7%), ulcershypersecretory states (7.7%), urinary tract disease (7.7%), malignancy (7.2%), and others. Although 5.3% of the patients died (related to presenting condition), most (61.3%) patients ultimately recovered. Surgical intervention was required for 22.1% of the patients. Variables associated with adverse outcomes (death, and need for surgical intervention) included hypotension, abnormalities on abdominal radiography, leukocytosis. ahnormal bowel sounds, and advanced age. Most physical examination findings were not helpful in identifying patients with adverse outcomes. This study demonstrated a higher incidence of malignancy (7.2%) and a lower incidence of disease necessitating surgical intervention (22.1%) than previously reported. Conclusions: The majority of geriatric emergency patients with abdominal pain have significant disease necessitating hospital admission. Morbidity and mortality among these patients are high, and specific variables are strongly associated with death and the need for surgical intervention. Absence of these variables does not preclude significant disease. Physical examination findings cannot reliably predict or exclude significant disease. These patients should be strongly considered for hospital admission, particularly when fever, hypotension, leukocytosis, or abnormal bowel sounds are present. Key words: abdominal pain; geriatrics; elder; adverse outcomes; predictors; diagnosis. ACADEMIC EMERGENCY MEDICINE 1998; 511163-1168 ERIATRIC persons (aged 65 years and older) G represent the fastest growing segment of the population, and currently comprise 12% of the U.S. population. The diseases of geriatric emergency patients have posed significant diagnostic and management challenges, in part due to patients' tendency to delay seeking medical care, the atypical presentations, presence of coexisting diseases, atypical physical examination findings, atypical laboratory values, and higher morbidity and mortality.l-I6 Previous studies have demonstrated a diagnostic accuracy of only 40% to 65% in geriatric patients with abdominal ~a i n . * -~.~, I~We undertook this investigation to ascertain fi- nal diagnoses and outcomes of geriatric ED patients with abdominal pain. We also wanted to determine which routinely available clinical variables are associated with higher likelihood of the need for surgical intervention, and death within a two-month period among this pa...

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Section: Discussionmentioning

confidence: 60%

Abdominal Pain in Geriatric Emergency Patients: Variables Associated with Adverse Outcomes

Marco

Schoenfeld

Keyl

et al. 1998

Academic Emergency Medicine

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“…Toplamda hastaların %33.3'ü bir servise takip ya da cerrahi müdahale için yatmıştır bu da başka çalış-malarla uyumludur (10). En çok medikal tedavi ile rahatlama sonucu taburcu olma tespit edilmesi nonspesifik ağ-rının daha çok tespit edilmesine bağlı olduğu düşünüldü.…”

Section: Discussionunclassified

Acil servisimize bir yıl süreyle başvuran travma dışı erişkin karın ağrılı hastaların incelemesi

Soyadı¹,

Yolcu²,

Beceren³

et al. 2015

GenelTipDer

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GirişTüm dünyada, Acil Servis'ler (AS) hastalara hizmetin kesintisiz bir şekilde sunulduğu bölümlerdir. AS' e başvuran hastalara hızlı, doğru ve kesintisiz hizmet verme zorunluluğu AS'i diğer bölümlerden farklı kılmaktadır. AS'ler ge- ARAŞTIRMA Genel Tıp DergisiAcil servisimize bir yıl süreyle başvuran travma dışı erişkin karın ağrılı hastaların incelemesi Hastaların, karın ağrısı başladıktan sonra %12.9'u ilk 6 saatte, %42.4'ü 6-12 saat arasında, %44.7'si 12 saatten sonra acil servise başvur-dukları tespit edildi. Sonuç: Çalışmamızla acil servise başvuran travma dışı erişkin hastalarda anamnez ve fizik muayenenin önemi tekrar ortaya kondu. Anamnez ve fizik muayeneyi takiben lüzum halinde acil hekimine yardımcı olabilecek gerekli olan laboratuvar tetkikleri, görüntüleme yöntemleri ve konsultasyonlar süratle yapılıp hastanın kesin tanısı konup gerekli işlemlerin yapılmasının önemi ortaya çıkmıştır. Ayrıca karın ağrılı hastaların acil servise karın ağrısını takiben erken dönemde başvurmadığı tespit edilmiş-tir, bu konuda halkımızın bilgilendirilmesi ve bu konularda eğitim verilmesi gerekliliği ortaya çıkmıştır. Bu alanda daha geniş çaplı araştırmalara ihtiyaç vardır. Anahtar sözcükler: Acil servis, laboratuar, karın ağrısı Evaluation of nontraumatic adult abdominal pain patients admitted to our emergency department during one yearObjectives: In this study, it was aimed to determine the frequency of the patients who came with the complaints of abdominal pain to our emergency service, the rate of those who hospitalized, distribution of disease which caused the abdominal pain, demographic characteristics, morbidity and mortality, to evaluate resaults which were received from the observations. Material and methods: Demographic characteristics, vital findings, physical examination findings, pain etymology, labratory and imaging tests, final diagnoses, consultations and the general condition of 1080 patients were evaluated between 12 March 2012-11March 2013. Results: While looking over the ages, youngest and oldest patient were 18 and 97 years old, respectively. The patients who admitted to emergency service were avaragely 41,9 years old and age pattern distribution observed homogeneous. While the patients classified from the perspective of gender, man are made up 39% (421 people), women are 61% (659 people). It has identified that the patients after the start of abdominal pain 12.9% first 6 hours, 42.4% between 6-12 hours, 44,7% after 12 hours were admitted to emergency service. Conclusion:In this study the importance of anamnesis and physical examination on the adult patients except trauma cases who admitted emergency service with the complaints of abdominal pain were stated. When anamnesis and physical examination are required to asist in case of needs of emergency physician, laboratory tests, imaging methods and consultations should be done quickly and put patient's final diagnosis, take necessary actions, were expressed. Finally, it is seen that the patients who have abdominal pain were not consulted emergency serv...

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“…Bugliosi et al [20] have reported that 23% of geriatric abdominal pain patients are diagnosed with nonspecific abdominal pain in the emergency department. AMI was diagnosed in 1.9% (n=13) of our patients, and this percentage is similar to that found in the literature.…”

Section: Discussionmentioning

confidence: 99%

Multidetector Angio-CT and the Use of D-Dimer for the Diagnosis of Acute Mesenteric Ischemia in Geriatric Patients

Gün

Yolcu

Değerli

et al. 2014

Ulus Travma Acil Cerrahi Derg

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Acute abdominal pain in the elderly

Cited by 111 publications

References 7 publications

Abdominal Pain in Geriatric Emergency Patients: Variables Associated with Adverse Outcomes

Abdominal Pain in Geriatric Emergency Patients: Variables Associated with Adverse Outcomes

Acil servisimize bir yıl süreyle başvuran travma dışı erişkin karın ağrılı hastaların incelemesi

Multidetector Angio-CT and the Use of D-Dimer for the Diagnosis of Acute Mesenteric Ischemia in Geriatric Patients

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