Publication: Acute abdominal pain and potential life-threatening outcome in adult patients presenting in emergency department Hospital Universiti Sains Malaysia
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Date
2020
Authors
Usaili, Zahril Akmal
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Abstract
Background Abdominal pain is one of the most common reasons for patient visits to the emergency department (ED). We aim to study the presentation of acute abdominal pain (AAP) in ED, the prevalence of potentially life-threatening AAP, and its associated factors. Methods This was a retrospective medical record review of ED visits for AAP among patients aged ≥12 years old from January to May 2018 at our suburban, academic tertiary centre ED in the east coast of Malaysia. A total of 945 cases were identified and 390 cases were selected by simple randomization. Results A total of 335 patients were included in the analysis. The mean age was 39.23±16.42 years. The majority were female (52.8%), Malays (95.2%), and came within 24 hours of the symptom (50.4%). The prevalence of potentially life-threatening AAP was 26% or 87 out of 335 patients. Its most frequent diagnosis was acute appendicitis (55.2%) followed by acute cholecystitis (11.5%) and ectopic pregnancy (6.9%). Factors predictive towards potentially life-threatening AAP were right iliac fossa pain (AOR 11.8, 95% CI 3.89 to 36.34, p<0.001), right hypochondriac pain (AOR 6.29, 95% CI: 1.61 to 24.67, p=0.008), generalized abdominal pain (AOR 6.28, 95% CI 1.39 to 28.43, p=0.017), loss of appetite (AOR 7.64, 95% CI 1.85 to 31.55, p=0.005), tachycardia (AOR 7.64, 95% CI 1.4 to 9.93, p=0.008), fever (AOR 2.8, 95% CI 1.05 to 7.44, p=0.039), leucocytosis (AOR 3.34, 95% CI 1.44 to 8.7, p=0.006) and low haemoglobin level (AOR 18.26, 95% CI 2.45 to 136, p=0.005). ConclusionA comprehensive history and clinical examination such as location of pain, loss of appetite, fever and tachycardia combined with laboratory testing to look for leucocytosis and anaemia may facilitate effective assessment in detecting potentially life-threatening AAP in ED
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Keywords
acute abdominal pain , emergency department