Gianfranco Cervellin1, Riccardo Mora2, Andrea Ticinesi2, Tiziana Meschi2, Ivan Comelli1, Fausto Catena3, Giuseppe Lippi4. 1. Emergency Department, Academic Hospital of Parma, Parma, Italy. 2. Postgraduate Emergency Medicine School, University of Parma, Parma, Italy. 3. Emergency and Trauma Surgery, Academic Hospital of Parma, Parma, Italy. 4. Section of Clinical Biochemistry, University of Verona, Verona, Italy.
Abstract
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.
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.
Entities:
Keywords:
Abdominal pain; Emergency Department (ED); appendicitis; epidemiology; nonspecific abdominal pain; renal colic; surgery
Authors: Nicolò Caporale; Antonio Maria Morselli-Labate; Elena Nardi; Rosanna Cogliandro; Mario Cavazza; Vincenzo Stanghellini Journal: United European Gastroenterol J Date: 2015-09-24 Impact factor: 4.623
Authors: Salomone Di Saverio; Mauro Podda; Belinda De Simone; Marco Ceresoli; Goran Augustin; Alice Gori; Marja Boermeester; Massimo Sartelli; Federico Coccolini; Antonio Tarasconi; Nicola De' Angelis; Dieter G Weber; Matti Tolonen; Arianna Birindelli; Walter Biffl; Ernest E Moore; Michael Kelly; Kjetil Soreide; Jeffry Kashuk; Richard Ten Broek; Carlos Augusto Gomes; Michael Sugrue; Richard Justin Davies; Dimitrios Damaskos; Ari Leppäniemi; Andrew Kirkpatrick; Andrew B Peitzman; Gustavo P Fraga; Ronald V Maier; Raul Coimbra; Massimo Chiarugi; Gabriele Sganga; Adolfo Pisanu; Gian Luigi De' Angelis; Edward Tan; Harry Van Goor; Francesco Pata; Isidoro Di Carlo; Osvaldo Chiara; Andrey Litvin; Fabio C Campanile; Boris Sakakushev; Gia Tomadze; Zaza Demetrashvili; Rifat Latifi; Fakri Abu-Zidan; Oreste Romeo; Helmut Segovia-Lohse; Gianluca Baiocchi; David Costa; Sandro Rizoli; Zsolt J Balogh; Cino Bendinelli; Thomas Scalea; Rao Ivatury; George Velmahos; Roland Andersson; Yoram Kluger; Luca Ansaloni; Fausto Catena Journal: World J Emerg Surg Date: 2020-04-15 Impact factor: 5.469
Authors: Minu Agarwal; Amar Udare; Michael Patlas; Milita Ramonas; Amer A Alaref; Radu Rozenberg; Donald L Ly; Dmitry S Golev; Ken Mascola; Christian B van der Pol Journal: CMAJ Open Date: 2020-09-14
Authors: Sophia Chikhladze; Ann-Kathrin Lederer; Stefan Fichtner-Feigl; Uwe A Wittel; Martin Werner; Konrad Aumann Journal: World J Clin Cases Date: 2020-01-06 Impact factor: 1.337
Authors: Massimo Sartelli; Federico Coccolini; Yoram Kluger; Ervis Agastra; Fikri M Abu-Zidan; Ashraf El Sayed Abbas; Luca Ansaloni; Abdulrashid Kayode Adesunkanmi; Boyko Atanasov; Goran Augustin; Miklosh Bala; Oussama Baraket; Suman Baral; Walter L Biffl; Marja A Boermeester; Marco Ceresoli; Elisabetta Cerutti; Osvaldo Chiara; Enrico Cicuttin; Massimo Chiarugi; Raul Coimbra; Elif Colak; Daniela Corsi; Francesco Cortese; Yunfeng Cui; Dimitris Damaskos; Nicola De' Angelis; Samir Delibegovic; Zaza Demetrashvili; Belinda De Simone; Stijn W de Jonge; Sameer Dhingra; Stefano Di Bella; Francesco Di Marzo; Salomone Di Saverio; Agron Dogjani; Therese M Duane; Mushira Abdulaziz Enani; Paola Fugazzola; Joseph M Galante; Mahir Gachabayov; Wagih Ghnnam; George Gkiokas; Carlos Augusto Gomes; Ewen A Griffiths; Timothy C Hardcastle; Andreas Hecker; Torsten Herzog; Syed Mohammad Umar Kabir; Aleksandar Karamarkovic; Vladimir Khokha; Peter K Kim; Jae Il Kim; Andrew W Kirkpatrick; Victor Kong; Renol M Koshy; Igor A Kryvoruchko; Kenji Inaba; Arda Isik; Katia Iskandar; Rao Ivatury; Francesco M Labricciosa; Yeong Yeh Lee; Ari Leppäniemi; Andrey Litvin; Davide Luppi; Gustavo M Machain; Ronald V Maier; Athanasios Marinis; Cristina Marmorale; Sanjay Marwah; Cristian Mesina; Ernest E Moore; Frederick A Moore; Ionut Negoi; Iyiade Olaoye; Carlos A Ordoñez; Mouaqit Ouadii; Andrew B Peitzman; Gennaro Perrone; Manos Pikoulis; Tadeja Pintar; Giuseppe Pipitone; Mauro Podda; Kemal Raşa; Julival Ribeiro; Gabriel Rodrigues; Ines Rubio-Perez; Ibrahima Sall; Norio Sato; Robert G Sawyer; Helmut Segovia Lohse; Gabriele Sganga; Vishal G Shelat; Ian Stephens; Michael Sugrue; Antonio Tarasconi; Joel Noutakdie Tochie; Matti Tolonen; Gia Tomadze; Jan Ulrych; Andras Vereczkei; Bruno Viaggi; Chiara Gurioli; Claudio Casella; Leonardo Pagani; Gian Luca Baiocchi; Fausto Catena Journal: World J Emerg Surg Date: 2021-09-25 Impact factor: 5.469