Abstract
Background: Obstetric and gynecological (OBGY) diseases are among the most important differential diagnoses for young women with acute abdominal pain. However, there are few established clinical prediction rules for screening OBGY diseases in the emergency department (ED). This study aimed to develop a prediction model for diagnosing OBGY diseases in the ED.Methods: This single-center retrospective cohort study included female patients with acute abdominal pain who presented to our emergency department. We developed a logistic regression model for predicting OBGY diseases and assessed its diagnostic ability. This study included young female patients aged between 16 and 49 years old, who had abdominal pain and were examined at the ED from April 2017 to March 2018. Trauma patients and patients referred from another hospital or from the OBGY department of our hospital were excluded.Results: Of 27,991 patients, 740 were included. Sixty-five patients were diagnosed with OBGY diseases (8.8%). The "POP" scoring system [past history of OBGY diseases +1, no other symptoms +1, and peritoneal irritation signs +1] was developed. Cut-off values set between 0 and 1 points, sensitivity at 97%, specificity at 39%, and negative likelihood ratio (LR-) of 0.08 were considered for rule-out, while cut-off values set between 2 and 3 points, sensitivity at 23%, specificity at 99%, and positive likelihood ratio (LR+) of 17.29 were suitable for rule-in.Conclusions: Our "POP" scoring system can be useful for screening of OBGY diseases in the ED.
Incidental appendectomy? Microscopy tells another story: A retrospective cohort study in patients presenting acute right lower quadrant abdominal pain
