The role of plain radiographs in patients with acute abdominal pain at the ED

Randen, Adriënne van; Laméris, Wytze; Luitse, Jan S. K.; Gorzeman, Michiel P; Hesselink, E. J.; Dolmans, Dennis E. J. G. J.; Peringa, Jan; Geloven, A. A. W. van; Bossuyt, Patrick M.; Stoker, Jaap; Boermeester, Marja A.

doi:10.1016/j.ajem.2009.12.020

Cited by 67 publications

(43 citation statements)

References 29 publications

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“…Despite reliable evidence of scarce diagnostic performance (26)(27)(28), plain abdomen X-ray is still widely prescribed in as many as 35-45% of all cases of AAP in different facilities (19,28).…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and outcomes of acute abdominal pain in a large urban Emergency Department: retrospective analysis of 5,340 cases

et al. 2016

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Background: Acute abdominal pain (AAP) accounts for 7-10% of all Emergency Department (ED) visits.Nevertheless, the epidemiology of AAP in the ED is scarcely known. The aim of this study was to investigate the epidemiology and the outcomes of AAP in an adult population admitted to an urban ED. Methods:We made a retrospective analysis of all records of ED visits for AAP during the year 2014. All the patients with repeated ED admissions for AAP within 5 and 30 days were scrutinized. Five thousand three hundred and forty cases of AAP were analyzed.Results: The mean age was 49 years. The most frequent causes were nonspecific abdominal pain (NSAP) (31.46%), and renal colic (31.18%). Biliary colic/cholecystitis, and diverticulitis were more prevalent in patients aged >65 years (13.17% vs. 5.95%, and 7.28% vs. 2.47%, respectively). Appendicitis (i.e., 4.54% vs. 1.47%) and renal colic (34.48% vs. 20.84%) were more frequent in patients aged <65 years. NSAP was the most common cause in both age classes. Renal colic was the most frequent cause of ED admission in men, whereas NSAP was more prevalent in women. Urinary tract infection was higher in women. Overall, 885 patients (16.57%) were hospitalized. Four hundred and eighty-five patients had repeated ED visits throughout the study period. Among these, 302 patients (6.46%) were readmitted within 30 days, whereas 187 patients (3.82%) were readmitted within 5 days. Renal colic was the first cause for ED readmission, followed by NSAP. In 13 cases readmitted to the ED within 5 days, and in 16 cases readmitted between 5-30 days the diagnosis was changed.Conclusions: Our study showed that AAP represented 5.76% of total ED visits. Two conditions (i.e., NSAP and renal colic) represented >60% of all causes. A large use of active clinical observations during ED stay (52% of our patients) lead to a negligible percentage of changing diagnosis at the second visit.

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Section: Discussionmentioning

confidence: 99%

Epidemiology and outcomes of acute abdominal pain in a large urban Emergency Department: retrospective analysis of 5,340 cases

et al. 2016

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“…The wide variety in presentation of symptoms and the broad spectrum of associated diseases complicates the isolation of the cause of abdominal pain, which may vary from life-threatening diseases requiring emergency surgery to mild self-limiting causes (Laméris et al 2009). The prevalence of patients with acute abdominal pain has been increasing over the years (Pitts et al 2008;van Randen et al 2011). Hastings and Powers (2011) conducted a retrospective study in patients with acute abdominal pain at three different time points over a period of 35 years, and reported that there was an increased tendency in the proportion of patients presenting with acute abdominal pain as a chief complaint.…”

Section: Introductionmentioning

confidence: 99%

Age-Related Differences in Outcomes and Etiologies of Acute Abdominal Pain Based on a National Administrative Database

Murata

Okamoto

Mayumi

et al. 2014

Tohoku J. Exp. Med.

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Acute abdominal pain is one of the most frequent causes of admission to emergency departments. However, there is a shortage of detail information showing the difference of outcomes or etiology of acute abdominal pain according to age. We therefore conducted an epidemiological analysis to reveal the difference between age on outcomes and etiology of acute abdominal pain using an administrative database associated with the Diagnosis Procedure Combination (DPC) system. We obtained discharge data relating to 12,209 patients with acute abdominal pain from 931 DPC participation hospitals between 2009 and 2011 in Japan. We compared length of hospital stay (LOS), in-hospital mortality, and etiology of acute abdominal pain between age categories. Patients were divided into five age groups as follows: < 20 (n = 1,106), 20-39 (n = 3,353), 40-59 (n = 2,925), 60-79 (n = 3,144), and ≥ 80 years (n = 1,681). Longer LOS and higher in-hospital mortality were observed in patients aged ≥ 80 years (p < 0.001). Regarding etiologies of acute abdominal pain, intestinal infection or acute appendicitis were more frequent in patients aged < 20 or 20-39 years, while ileus or cholelithiasis were more frequent in patients aged 60-79 or ≥ 80 years in both male and female patients (p < 0.001). This study demonstrated the significant differences between age with regard to the patient outcomes and etiology of acute abdominal pain. The current findings highlight the importance of improving the quality of medical care for patients with acute abdominal pain.

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“…In studies published by Randen A et al and Allemen F et al, the mean age reported was 47 and 45 years respectively. 5,6 There were 26 (65%) males and 14 (35%) females in the study. The male preponderance correlates with the studies done by Nega B et al 7 The most common diagnosis was acute appendicitis (32.5%) followed by cholelithiasis (20%) and urolithiasis (15%) in that descending order.…”

Section: Discussionmentioning

confidence: 99%

Results of emergency management of acute abdomen in adults based on clinical assessment and basic imaging investigations: are advanced imaging techniques always necessary for successful treatment?

Karandikar¹

2016

Int J Res Med Sci

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The role of plain radiographs in patients with acute abdominal pain at the ED

Cited by 67 publications

References 29 publications

Epidemiology and outcomes of acute abdominal pain in a large urban Emergency Department: retrospective analysis of 5,340 cases

Epidemiology and outcomes of acute abdominal pain in a large urban Emergency Department: retrospective analysis of 5,340 cases

Age-Related Differences in Outcomes and Etiologies of Acute Abdominal Pain Based on a National Administrative Database

Results of emergency management of acute abdomen in adults based on clinical assessment and basic imaging investigations: are advanced imaging techniques always necessary for successful treatment?

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