Final diagnosis of the patients presented with abdominal pain to the emergency department at King Khalid General Hospital, Majmaah, Saudi Arabia (2017)

Objective. We aimed to identify factors affecting length of stay in the emergency department in patients who presented with abdominal pain. Methods. A retrospective cohort study was conducted from 1 January 2017 to 31 December 2017. The medical records were reviewed from 217 patients older than 15 years with the chief complaint of abdominal pain. The patients were divided into emergency department length of stay (EDLOS) < 4 hours and ≥4 hours. The two groups were compared in terms of baseline characteristics, physical examination, time of presenting, attending physicians, interdepartmental consultations, investigations, ED disposition, final diagnosis, and mortality. The significant factors affecting longer EDLOS were examined using univariate and multivariate analyses by logistic regression. Results. Factors affecting longer EDLOS were age ≥50 (odds ratio (OR) 3.17, 95% confidence interval (CI) 1.36–7.42), interdepartmental consultation ≥2 specialists (OR 71.82, 95% CI 5.67–909.51), blood testing ≥2 rounds (OR 85.6, 95% CI 4.22–1734.6), and ultrasonography (OR 8.28, 95% CI 1.84–37.26). Conclusion. The study found that the statistically significant factors that prolonged EDLOS in patients with the chief complaint of abdominal pain were age, rounds of blood test, interdepartmental consultation, and the need for ultrasonography.

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Utility of a Bedside Pocket-Sized Ultrasound Device to Promptly Manage Abdominal Pain in the Emergency Department

Mediterranean Journal of Emergency Medicine & Acute Care ◽

10.52544/2642-7184(1)1001 ◽

2019 ◽

Vol 1 (1) ◽

pp. 13-21

Keyword(s):

Emergency Department ◽

Abdominal Pain ◽

Imaging Modality ◽

Low Cost ◽

Tertiary Care ◽

Area Under The Curve ◽

Final Diagnosis ◽

University Hospital ◽

Operating Characteristics ◽

Early Assessment

Introduction: Abdominal pain is a frequent reason for Emergency Department (ED) admission; it amounts for around 5–10% of all ED visits. Early assessment should focus on immediately distinguishing cases of acute abdomen that require urgent surgical intervention. The clinical localization of pain is crucial, suggesting an initial evaluation of the origin of the abdominal pain; however, imaging is often required for final diagnosis. Ultrasound (US) represents a rapid imaging modality that is readily available in the ED and does not involve radiation or contrast agent administration. A new generation of portable, battery-powered, low-cost, hand-carried ultrasound devices have become available recently; these devices can provide immediate diagnostic information in patients presenting with abdominal pain in ED.The aim of the study was to demonstrate the diagnostic usefulness of a bedside pocket-sized ultrasound (BPU) device (Vscan from General Electrics) in non-traumatic patients complaining of acute abdominal pain in a tertiary care university hospital in Italy. Methods: Patients with acute non-traumatic abdominal pain presenting in ED were prospectively enrolled and underwent physical examination, traditional imaging and BPU. Results: A total number of 230 patients with acute non-traumatic abdominal pain were enrolled. Overall agreement between routine standard imaging and BPU turned out to be equal for computed tomography (K=0.3) and traditional ultrasound (K=0.29). Receiver operating characteristics curve (ROC) analysis for diagnostic power of the BPU in comparison with traditional US showed an area under the curve of 0.65, sensitivity and specificity of 87.2% and 42.31% respectively. Conclusions: Emergency use of BPU in patients with non-traumatic abdominal pain demonstrated good diagnostic performance when compared to traditional imaging, with the potential advantage of reducing costs and delay in patient final disposition.

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

Gastroenterology Research and Practice ◽

10.1155/2015/590346 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 6

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.

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Trauma patterns in patients attending the Emergency Department of Jazan General Hospital, Saudi Arabia

World Journal of Emergency Medicine ◽

10.5847/wjem.j.1920-8642.2015.01.009 ◽

2015 ◽

Vol 6 (1) ◽

pp. 48 ◽

Cited By ~ 5

Author(s):

Emad Hokkam ◽

Abdelaziz Gonna ◽

Ossama Zakaria ◽

Amany El-shemally

Keyword(s):

Emergency Department ◽

Saudi Arabia ◽

General Hospital

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

Disease Markers ◽

10.1155/2018/6457347 ◽

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.

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Bedside ultrasound in the emergency department and abdominal pain

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/s-0036-1587879 ◽

2016 ◽

Vol 37 (S 01) ◽

Author(s):

M Algaba Montes ◽

AÁ Oviedo García ◽

M Patricio Bordomás

Keyword(s):

Emergency Department ◽

Abdominal Pain ◽

Bedside Ultrasound

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Bayesian Diagnostic Probabilities without Assuming Independence of Symptoms

Methods of Information in Medicine ◽

10.1055/s-0038-1634813 ◽

1991 ◽

Vol 30 (01) ◽

pp. 15-22 ◽

Cited By ~ 23

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.

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Pain assessment and management for children hospitalized in the Pediatric Emergency Department, Military hospital, Al-Kharj, Saudi Arabia

International Journal of Medicine in Developing Countries ◽

10.24911/ijmdc.51-1553413977 ◽

2019 ◽

pp. 1

Author(s):

Abbas Khalid

Keyword(s):

Emergency Department ◽

Saudi Arabia ◽

Pain Assessment ◽

Pediatric Emergency ◽

Military Hospital ◽

Pediatric Emergency Department

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Identification Pseudomonas aeruginosa by OprD Gene for Differentiation from Other Pseudomonas Species that Isolated from Clinical Samples

International Journal of Drug Delivery Technology ◽

10.25258/ijddt.9.1.8 ◽

2019 ◽

Vol 9 (01) ◽

pp. 46-50

Author(s):

Ashwak B Al-Hashimy ◽

Huda S Alagely ◽

Akeel K Albuaji ◽

Khalid R Majeed

Keyword(s):

Pseudomonas Aeruginosa ◽

General Hospital ◽

Culture Media ◽

Final Diagnosis ◽

Clinical Samples ◽

Bacterial Isolates ◽

Molecular Method ◽

Biochemical Tests ◽

Pseudomonas Species ◽

Specific Sequences

The present study included the collection of 100 samples from various clinical sources for investigating the presence of P. aeruginosa in those sources, the samples have been collected from some hospitals in Baghdad and Hillah city (Al-qassim General Hospital, ,Al-hillah teaching hospital,and Al-hashimya General hospital ) which included wounds, burns, ear and sputum infections. The study was carried out through October 2017 till the end of March 2018. The samples were identified based on the morphological and microscopically characteristics of the colonies when they were culturing or number of culture media as well as biochemical tests, molecular identification were also used as a final diagnostic test for isolates that were positive as they belong to P.aeruginosa bacteria during previous tests based on the OprD gene which has specific sequences for P.aeruginosa bacteria as a detection gene and also consider as virulence factor so it have a synonyms mechanism to antibiotic resistance . The results of the final diagnosis showed that 38 isolates belong to target bacteria were distributed as 18 of burns, 11 isolates of wounds, 6 isolates of ear infection and 3 isolates of sputum, The examination of the sensitivity of all bacterial isolates was done for elected 38 isolation towards the 9 antibiotic by a Bauer - Kirby and the isolates were resistant for a number of antibiotics used such as Ciprofloxacin 65.7%, Norflaxacin 71%, Imipenem 63.1% Meropenem 68.4%, Gentamicin 65.7%, Amikacin 26.3%, Cefepime 68.4%, Ceftazidime 65.7% and Piperacillin 57.8%.Molecular method , All isolates (38) of P. aeruginosa positive for the diagnostic special gene (OprD) genes (100%).

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