scholarly journals Impact of Clinical Experience and Diagnostic Performance in Patients with Acute Abdominal Pain

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Helena Laurell ◽  
Lars-Erik Hansson ◽  
Ulf Gunnarsson
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Diagnostic Performance ◽  
Acute Abdominal Pain ◽  
Final Diagnosis ◽  
Emergency Department Physician ◽  
Time Of Arrival ◽  
Base Line ◽  
Preliminary Diagnosis ◽  
One Year

Background.The aims were to evaluate the importance of the formal competence of the emergency department physician, the patient’s time of arrival at the emergency department, and the use of a structured schedule for investigation of patients with acute abdominal pain.Methods.Patients attending the Mora Hospital with acute abdominal pain from 1997 to 2000 were registered prospectively according to a structured schedule. Registration included history, symptoms, signs, preliminary diagnosis, surgery and final diagnosis after at least one year.  Results.3073 acute abdominal pain patients were included. The preliminary diagnosis, as compared with the final diagnosis, was correct in 54%(n=1659). Previously, during 1996, a base-line registration of 790 patients had a 58% correct diagnoses  (n=458). A majority of the patients (n=2699; 88%) were managed by nonspecialists. The proportion of correct diagnoses was 54%(n=759)for pre-registrar house officers and 55%(n=443)for senior house officers. Diagnostic performance at the emergency department was independent of patient’s time of arrival.Conclusions.A structured schedule for investigation did not improve the diagnostic precision at the emergency department in patients with acute abdominal pain. The diagnostic performance was independent of the formal competence of the physician and the patient's time of arrival.

scholarly journals Diagnostic Accuracy of Serum and Urine S100A8/A9 and Serum Amyloid A in Probable Acute Abdominal Pain at Emergency Department

2018 ◽  
Vol 2018 ◽  
pp. 1-10
Author(s):  
Arash Forouzan ◽  
Kambiz Masoumi ◽  
Fakher Rahim ◽  
Meisam Moezzi ◽  
Ali Khavanin ◽  
...  
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Diagnostic Accuracy ◽  
Serum Amyloid A ◽  
Acute Abdominal Pain ◽  
Final Diagnosis ◽  
Serum Amyloid ◽  
Amyloid A ◽  
Significant Difference ◽  
Serum And Urine

Study Design. This study was performed to investigate the diagnostic values of some inflammatory biomarkers in abdominal pain. Methods. Patients over 18 years of age with acute recent abdominal pain who presented to the Emergency Department were evaluated. Serum and urinary samples were taken and evaluated for serum and urine S100A8/A9 and serum amyloid A. All patients were referred to a surgeon and were followed up until the final diagnosis. In the end, the final diagnosis was compared with the levels of biomarkers. Results. Of a total of 181 patients, 71 underwent surgery and 110 patients did not need surgery after they were clinically diagnosed. Mean levels of serum and urine S100A8/A9 had a significant difference between two groups, but serum amyloid A did not show. The diagnostic accuracy of serum S100A8/A9, urine S100A8/A9, and serum amyloid A was 86%, 79%, and 50%, respectively, in anticipation of the need or no need for surgery in acute abdominal pain. Conclusions. Our study showed that in acute abdominal pain, serum and urine S100A8/A9 can be useful indicators of the need for surgery, but serum amyloid A had a low and nonsignificant diagnostic accuracy.

Bayesian Diagnostic Probabilities without Assuming Independence of Symptoms

1991 ◽  
Vol 30 (01) ◽  
pp. 15-22 ◽  
Author(s):  
A. Gammerman ◽  
A. R. Thatcher
Keyword(s):  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Final Diagnosis ◽  
Bayes Theorem ◽  
Bayes Method ◽  
Hospital Records ◽  
Computer Diagnosis ◽  
Bayes Model ◽  
Chi Squared ◽  
Past Data

The paper describes an application of Bayes’ Theorem to the problem of estimating from past data the probabilities that patients have certain diseases, given their symptoms. The data consist of hospital records of patients who suffered acute abdominal pain. For each patient the records showed a large number of symptoms and the final diagnosis, to one of nine diseases or diagnostic groups. Most current methods of computer diagnosis use the “Simple Bayes” model in which the symptoms are assumed to be independent, but the present paper does not make this assumption. Those symptoms (or lack of symptoms) which are most relevant to the diagnosis of each disease are identified by a sequence of chi-squared tests. The computer diagnoses obtained as a result of the implementation of this approach are compared with those given by the “Simple Bayes” method, by the method of classification trees (CART), and also with the preliminary and final diagnoses made by physicians.

scholarly journals Role of emergency physician–performed ultrasound in the differential diagnosis of abdominal pain

2018 ◽  
Vol 27 (2) ◽  
pp. 79-86
Author(s):  
Nalan Kozaci ◽  
Mustafa Avci ◽  
Gul Tulubas ◽  
Ertan Ararat ◽  
Omer Faruk Karakoyun ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Emergency Physician ◽  
Gold Standard ◽  
Acute Abdominal Pain ◽  
Point Of Care ◽  
Final Diagnosis ◽  
Free Fluid ◽  
Emergency Physicians ◽  
Abdominal Ultrasonography

Objectives: This prospective study was performed to evaluate the diagnostic accuracy of bedside point-of-care abdominal ultrasonography performed by emergency physician in patients with non-traumatic acute abdominal pain. Methods: The patients, who were admitted to emergency department due to abdominal pain, were included in this study. The emergency physician obtained a routine history, physical examination, blood draws, and ordered diagnostic imaging. After the initial clinical examinations, all the patients underwent ultrasonography for abdominal pathologies by emergency physician and radiologist, respectively. Point-of-care abdominal ultrasonography compared with abdominal ultrasonography performed by radiologist as the gold standard. Results: The study included 122 patients. Gallbladder and appendix pathologies were the most commonly detected in the abdominal ultrasonography. Compared with abdominal ultrasonography, point-of-care abdominal ultrasonography was found to have 89% sensitivity and 94% specificity in gallbladder pathologies; 91% sensitivity and 91% specificity in acute appendicitis; 79% sensitivity and 97% specificity in abdominal free fluid; 83% sensitivity and 96% specificity in ovarian pathologies. Compared to final diagnosis, preliminary diagnoses of emergency physicians were correct in 92 (75.4%) patients. Conclusion: This study showed that emergency physicians were successful in identifying abdominal organ pathologies with point-of-care abdominal ultrasonography after training.

scholarly journals Imaging of non-traumatic acute abdominal pain in adults presenting to the emergency department

2016 ◽  
Vol 37 (3) ◽  
pp. 324-327 ◽  
Author(s):  
Mohamed Abd El Bagi ◽  
Badr Almutairi ◽  
Sami Alsolamy
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Acute Abdominal Pain

Analgesic Access for Acute Abdominal Pain in the Emergency Department Among Racial/Ethnic Minority Patients

Medical Care ◽  
2015 ◽  
Vol 53 (12) ◽  
pp. 1000-1009 ◽  
Author(s):  
Adil A. Shah ◽  
Cheryl K. Zogg ◽  
Syed Nabeel Zafar ◽  
Eric B. Schneider ◽  
Lisa A. Cooper ◽  
...  
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Ethnic Minority ◽  
Acute Abdominal Pain ◽  
Racial Ethnic

Unscheduled Revisits after Diagnosis of Abdominal Pain at Emergency Department, Mukdahan Hospital

2021 ◽  
Vol 104 (Suppl. 1) ◽  
pp. S40-S43
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Patient Care ◽  
Acute Abdominal Pain ◽  
Signs And Symptoms ◽  
Discharge System ◽  
Effective Discharge ◽  
Time Period ◽  
Pain Patients

Background: Abdominal pain is a common complaint for patients revisiting the Emergency Department (ED). Evaluating the cause of the revisit can improve the quality of ED patient care. Objective: We aimed to analyzed unscheduled revisits after diagnosis of abdominal pain at emergency department. Materials and Methods: In order to determine the characteristics of their abdominal pain and the causes for the revisits, the charts of 90 patients were reviewed. These patients had experienced acute abdominal pain and had returned to the Emergency Department within 48 hours after their initial treatment during the period between January 2019 and December 2019. Results: During that time period, 44,000 patients visited the ED. Of these, 90 patients (0.2%) with acute abdominal pain or related symptoms had revisited the ED within the following 48 hours. Most of these patients had been 20 to 60 years of age and had had no co-morbid diseases. Almost half of patient revisits had occurred during the evening shift (45.6%). There were 74% of these patients, who had been admitted to hospital for observation or for procedures. No in-hospital mortality was reported for this study. The signs and symptoms of abdominal pain in these patients had not been specific. The factors, which most often contributed to the ED revisits, had been inappropriate consultations and inappropriate discharges or advises. Conclusion: The majority of the acute abdominal pain patients, who revisited the ED within 48 hours, had been admitted. The most common cause of revisits had been inappropriate consultations and inappropriate discharges. Improving ED patient care can be managed by contributing to effective consultations and to establishing an effective discharge system for the ED. Keywords: Revisits, Emergency medicine department, Acute abdominal pain

scholarly journals Prevalence of pneumonia in children under 12 years of age who undergo abdominal radiography in the emergency department

CJEM ◽  
2007 ◽  
Vol 9 (05) ◽  
pp. 347-351 ◽  
Author(s):  
Valérie Homier ◽  
Colette Bellavance ◽  
Marianne Xhignesse
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Chest Radiograph ◽  
Chest Radiography ◽  
Acute Abdominal Pain ◽  
Tertiary Care ◽  
Abdominal Radiograph ◽  
Upper Respiratory Tract ◽  
Abdominal Radiography ◽  
X Ray

ABSTRACT Objective: Pneumonia is a well-known cause of acute abdominal pain in children. However, the utility of chest radiography in this setting is controversial. We sought to determine the prevalence of pneumonia in children under 12 years of age who had abdominal pain and underwent abdominal radiography when visiting an emergency department (ED). We also aimed to describe the signs and symptoms of children diagnosed with pneumonia in this context. Methods: We conducted a retrospective analysis of electronic data from ED visits to a tertiary care centre by children 12 years of age and under who were seen between June 1, 2001, and June 30, 2003, and who underwent both an abdominal and a chest radiograph during the same visit, or an abdominal x-ray at a first visit as well as a chest x-ray in the 10 days following the initial visit. Results: Of 1584 visits studied, 30 cases of pneumonia were identified, for a prevalence of 1.89% (95% confidence interval 1.22%–1.56%). If chest radiography had been limited to children who presented with fever, cough and symptoms of an upper respiratory tract infection (URTI), the diagnosis of pneumonia would have been missed in only 2/1584 visits (0.13%). Conclusion: Children aged 12 years and under presenting to the ED with acute abdominal pain and in whom an abdominal radiograph is requested need only undergo a chest radiograph in the presence of cough, fever or other symptoms of a URTI.

scholarly journals Randomized Trial of Intravenous Lidocaine Versus Hydromorphone for Acute Abdominal Pain in the Emergency Department

2019 ◽  
Vol 74 (2) ◽  
pp. 233-240 ◽  
Author(s):  
Elliott Chinn ◽  
Benjamin W. Friedman ◽  
Farnia Naeem ◽  
Eddie Irizarry ◽  
Freda Afrifa ◽  
...  
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Randomized Trial ◽  
Acute Abdominal Pain ◽  
Intravenous Lidocaine

scholarly journals Effectively reducing amylase testing using computer order entry in the emergency department: quality improvement without eliminating physician choice

2017 ◽  
Vol 24 (3) ◽  
pp. 257 ◽  
Author(s):  
Cassie Jaeger ◽  
Paul Sullivan ◽  
James Waymack ◽  
David Griffen Griffen
Keyword(s):  
Emergency Department ◽  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Diagnostic Testing ◽  
Value Added ◽  
Diagnostic Value ◽  
Order Entry ◽  
Computerized Provider Order Entry ◽  
Quality Patient Care ◽  
One Year

Background Amylase and lipase, pancreatic biomarkers, are measured in acute pancreatitis diagnosis. Since amylase testing does not add diagnostic value, lipase testing alone is recommended. Despite new recommendations, many physicians and staff continue to test both amylase and lipase.Objective To reduce unnecessary diagnostic testing in acute pancreatitis.Methods The pre-checked amylase test within the Emergency Department’s Computerized Provider Order Entry (CPOE) abdominal pain order set was changed to an un-checked state, but kept as an option to order with a single click. Amylase testing, lipase testing and cost were measured for one year pre and post intervention.Results Simple de-selection intervention reduced redundant amylase testing from 71% to 9%, resulting in a percent of decrease of 87% and an annualized saving of approximately $719,000 in charges.Conclusion CPOE de-selection is an effective tool to reduce non-value added activity and reduce cost while maintaining quality patient care and physician choice.

Sign in / Sign up

Export Citation Format

Share Document