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2017 ; 9
(12
): 987-993
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Acute Abdominal Pain Assessment in the Emergency Department: The Experience of a
Greek University Hospital
#MMPMID29163731
Velissaris D
; Karanikolas M
; Pantzaris N
; Kipourgos G
; Bampalis V
; Karanikola K
; Fafliora E
; Apostolopoulou C
; Gogos C
J Clin Med Res
2017[Dec]; 9
(12
): 987-993
PMID29163731
show ga
BACKGROUND: Acute abdominal pain (AAP) is a common symptom in the emergency
department (ED). Because abdominal pain can be caused by a wide spectrum of
underlying pathology, evaluation of abdominal pain in the ED requires a
comprehensive approach, based on patient history, physical examination,
laboratory tests and imaging studies. The aim of this study was to investigate
predictive factors for admission to the hospital in patients who presented to the
ED with AAP as the main symptom. METHODS: This prospective observational study
enrolled 125 patients who presented with AAP in the ED of the Patras University
Hospital in western Greece. The sample of patients who enrolled in the study was
representative of patients who receive care in this academic institution. All
patients underwent clinical examination, laboratory testing and radiological
assessment. Clinical and laboratory data were analyzed in an attempt to identify
clinical or laboratory factors predicting hospital admission. RESULTS: Based on
clinical, laboratory and radiologic evaluation, 37.6% of patients enrolled in the
study were admitted to the hospital, whereas 62.4% were not admitted. Compared to
patients who were not admitted, patients admitted to the hospital had higher age
and significantly higher inflammatory markers, white blood count and C-reactive
protein (CRP). Binary logistic regression analysis showed that abnormal imaging
findings (odds ratio (OR) = 6.47, 95% confidence interval (CI): 2.11 - 19.77, P <
0.001) and elevated serum CRP levels (OR = 6.24, 95% CI: 2.16 - 18.03, P < 0.001)
were significant predictive factors for hospital admission. CONCLUSIONS:
Assessment of AAP remains a challenging problem in the ED. Comprehensive history
combined with detailed clinical examination, appropriate laboratory testing and
radiologic imaging facilitates effective assessment of patients who present in
the ED with AAP and guides the decision to admit patients to the hospital for
further care.