Evidence-Based Medicine Approach to Abdominal Pain

Natesan, Sreeja; Lee, Jerry; Volkamer, Heather; Thoureen, Traci

doi:10.1016/j.emc.2015.12.008

Cited by 46 publications

(25 citation statements)

References 104 publications

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“…Nontraumatic acute abdominal pain (AAP) is the cause of 5% to 10% of all emergency department (ED) accesses (Natesan et al, 2016). AAP can be a presenting symptom in many diseases, ranging from mild gastroenteric illnesses to life‐threatening diseases (Palmer & Pontius, 2016).…”

Section: Introductionmentioning

confidence: 99%

Acute abdominal pain in triage: A retrospective observational study of the Manchester triage system’s validity

Zaboli

Ausserhofer

Pfeifer

et al. 2021

Journal of Clinical Nursing

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Objective Roughly 5% to 10% of patients admitted to the emergency department suffer from acute abdominal pain. Triage plays a key role in patient stratification, identifying patients who need prompt treatment versus those who can safely wait. In this regard, the aim of this study was to estimate the performance of the Manchester Triage System in classifying patients with acute abdominal pain. Methods A total of 9,851 patients admitted at the Emergency Department of the Merano Hospital with acute abdominal pain were retrospectively enrolled between 1 January 2017 and 30 June 2019. The study was conducted and reported according to the STROBE statement. The sensitivity and specificity of the Manchester Triage System were estimated by verifying the triage classification received by the patients and their survival at seven days or the need for acute surgery within 72 h after emergency department access. Results Among the patients with acute abdominal pain (median age 50 years), 0.4% died within seven days and 8.9% required surgery within 72 hours. The sensitivity was 44.7% (29.9–61.5), specificity was 95.4% (94.9–95.8), and negative predictive value was 99.7% (99.2–100) in relation to death at seven days. Conclusions The Manchester Triage System shows good specificity and negative predictive value. However, its sensitivity was low due to the amount of incorrect triage prediction in patients with high‐priority codes (red/orange), suggesting overtriage in relation to seven‐day mortality. This may be a protective measure for the patient. In contrast, the need for acute surgery within 72 h was affected by under‐triage. Relevance to clinical practice The triage nurse using Manchester Triage System can correctly prioritise the majority of patients with acute abdominal pain, especially in low acuity patients. The Manchester Triage System is safe and does not underestimate the severity of the patients.

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Section: Introductionmentioning

confidence: 99%

Acute abdominal pain in triage: A retrospective observational study of the Manchester triage system’s validity

Zaboli

Ausserhofer

Pfeifer

et al. 2021

Journal of Clinical Nursing

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“…Within the literature, several empirical studies have examined the utility of CRP testing in the triage 66 and diagnosis 67,68 of acute abdominal pain, as well as its role in the evaluation of patients presenting to the ED with chest pain. 69,70 In addition, numerous guidelines are available to assist ED clinicians with assessing both abdominal pain 41,42,[71][72][73] and chest pain 49,71,74 ; however, the choice of diagnostic test(s) can be affected by a range of factors, including patient history, symptoms, and physical examination, 41,49,73 and ultimately clinical judgment. 71 Thus, the interpretation of the findings from our study needs to be reviewed in the context of each ED setting and the characteristics of its patient presentations, as recommended by Buchan et al 12 and Bojakowski, 75 who have highlighted the need for local-level contextualized evaluation in determining why variations exist.…”

Section: Discussionmentioning

confidence: 99%

The NSW Pathology Atlas of Variation: Part I—Identifying Emergency Departments With Outlying Laboratory Test–Ordering Practices

Wabe

Thomas

Scowen

et al. 2021

Annals of Emergency Medicine

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“…Abdominal pain is one of the most common complaints of patients admitted to emergency units, accounting for 5% -10% of all presentations. 1,2,3 Evaluation of the emergency department patient with acute abdominal pain may be difficult as several factors can obscure the clinical findings resulting in incorrect diagnoses and subsequent adverse outcomes. 4 Primary care practitioners must therefore consider multiple diagnoses whilst giving priority to lifethreatening conditions that require meticulous management to prevent morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

A primary care approach to abdominal pain in adults

Govender

Rangiah

Bongongo

et al. 2021

South African Family Practice

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Abdominal pain is a common presenting problem with multiple aetiologies that often pose diagnostic and therapeutic dilemmas for primary care practitioners. The vague symptomatology and difficult correlation to specific organ pathology obscures clinical findings leading to incorrect diagnoses. Although most presentations of abdominal pain are benign, a significant number of patients have life-threatening conditions that require a meticulous approach to management in order to prevent morbidity and mortality.The skill in assessing patients presenting with abdominal pain is fundamental for all primary care doctors. This review will discuss an approach to the assessment and diagnosis of abdominal pain in the primary care setting.

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Evidence-Based Medicine Approach to Abdominal Pain

Cited by 46 publications

References 104 publications

Acute abdominal pain in triage: A retrospective observational study of the Manchester triage system’s validity

Acute abdominal pain in triage: A retrospective observational study of the Manchester triage system’s validity

The NSW Pathology Atlas of Variation: Part I—Identifying Emergency Departments With Outlying Laboratory Test–Ordering Practices

A primary care approach to abdominal pain in adults

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