Hospital Admissions of Patients Aged Over 80 with Acute Abdominal Complaints

Geloven, A. A. W. van; Biesheuvel, Tessa H.; Luitse, Jan S. K.; Hoitsma, H. F. W.; Obertop, H.

doi:10.1080/110241500447254

Cited by 52 publications

(28 citation statements)

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“…The lower frequency of such complaints in older patients might explain the decreased proportion of women among the patients aged 65-79. Both the proportion of women and the incidence of surgery were found to be higher in a previous Swedish study [6] , as well as in some other studies [14,15] . One reason for the higher incidence of surgery compared with that in the present study may be the prospective nature of the latter, which meant a more complete inclusion of the whole group of patients with acute abdominal pain, not only those requiring surgery.…”

Section: Discussionmentioning

confidence: 57%

“…Diagnosing acute abdominal pain in older patients at the ED was more difficult, and hence less accurate, than in younger patients, as pointed out in previous reports [10,14] . The exact proportion of correct diagnoses is not directly comparable to that in previous studies, as it partly depends on the number of choices possible (in our study 26 diagnoses).…”

Section: Discussionmentioning

confidence: 75%

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Acute Abdominal Pain among Elderly Patients

2006

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Background: Diagnosis of acute abdominal pain in older persons is a challenge, with the age-related increase in concurrent diseases. In most western countries the number of elderly people is constantly rising, which means that an increasing proportion of patients admitted for abdominal pain at the emergency department are elderly. Objective: To characterize differences in clinical presentation and diagnostic accuracy between younger and more elderly patients with acute abdominal pain. Methods: Patients admitted to Mora Hospital with abdominal pain of up to seven days’ duration were registered according to a detailed schedule. From 1st February 1997 to 1st June 2000, 557 patients aged 65–79 years and 274 patients aged ≧80 years were registered. Patients aged 20–64 years (n = 1,458) served as a control group. Results: A specific diagnosis, i.e. other than ‘nonspecific abdominal pain’, was established in 76 and 78% of the patients aged 65–79 and ≧80 years respectively, and in 64% of those aged 20–64 (p < 0.001). Pain duration before admission increased with age (p < 0.003), as did frequency and duration of hospitalization (p < 0.0001). Hospital stay increased from 170 days per 100 emergency admissions in the control group to 320 and 458 days in the younger and older study groups, respectively. At the emergency department, older patients were more often misdiagnosed than control patients (52 vs. 45%; p = 0.002). At discharge the diagnosis was more accurate in the control group (86 vs. 77%; p < 0.0001). Hospital mortality was higher among older patients (23/831 vs. 2/1,458; p < 0.001). The admission-to-surgery interval was increased (1.8 vs. 0.9 days, p < 0.0001) in patients ≧65 years. Rebound tenderness (p < 0.0001), local rigidity (p = 0.003) and rectal tenderness (p = 0.004) were less common in the older than in the control patients with peritonitis. In patients ≧65 years, C-reactive protein did not differ between patients operated on and those not, contrary to the finding in patients <65 years (p < 0.0001). Conclusion: Both the preliminary diagnosis at the emergency department and the discharge diagnosis were less reliable in elderly than in younger patients. Elderly patients more often had specific organic disease and arrived at the emergency department after a longer history of abdominal pain compared to younger patients.

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Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 75%

Acute Abdominal Pain among Elderly Patients

2006

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“…With the active participation of older people in society, the term "super elderly", or "very elderly", has appeared in the literature, represented by individuals with over 80 years 4,5 . It is believed that this subgroup of patients presents a greater impairment of functional organic reserve even before suffering a trauma, which warrants special attention both from diagnosis and therapeutic standpoints 1,5,6 . There are not many studies that address the specific characteristics of traumatized "very old", neither comparing the lesions found in elderly patients over and under 80 years 4 .…”

mentioning

confidence: 99%

Análise comparativa das características do trauma entre idosos com idade superior e inferior a 80 anos

Parreira

Farrath

Soldá

et al. 2013

Rev. Col. Bras. Cir.

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OBJETIVO: comparar as características do trauma entre idosos e "superidosos". MÉTODOS: análise retrospectiva dos protocolos de vítimas de trauma fechado com idade igual ou superior a 70 anos. Os idosos de idade entre 70 e 79 anos foram incluídos no grupo I, os de idade igual ou maior de 80 anos no grupo II. Análise estatística foi realizada através dos testes t de Student, qui-quadrado e Fisher, considerando p<0,05 significativo. RESULTADOS: Foram incluídos no estudo 281 doentes (grupo I-149; grupo II-132). A idade variou de 70 a 99 anos (79,1 ± 6,7 anos), sendo 52,3% do sexo masculino. Os superidosos se caracterizaram por apresentar menor média de AIS em abdome (0,10 ± 0,59 vs. 0,00 ± 0,00; p=0,029), menor frequência de vítimas do sexo masculino (59,1% vs. 44,3%; p=0,013), maior frequência de queda da própria altura (44,3% vs. 65,2%; p=0,028) e menor frequência de fraturas de membros superiores (9,4% vs. 2,3%; p=0,010). Não observamos diferença significativa na comparação das demais variáveis entre os grupos. CONCLUSÃO: O trauma em idosos é um grave problema de saúde pública, com tendência à piora progressiva pelo envelhecimento da população. Os dados deste estudo nos auxiliam com uma visão mais clara do trauma nos superidosos, um subgrupo que merece atenção especial.

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“…It is estimated that in around 20% of cases the diagnosis recorded at discharge or autopsy is not the same as the diagnosis made on admission 24 . Mortality reached 59% in one group of patients whose severe injuries were not diagnosed promptly 24 . It is believed that 32% of deaths of elderly trauma victims were the consequence of avoidable complications 25 .…”

Section: Discussionmentioning

confidence: 99%