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[对因非特异性腹痛从急诊科出院患者的一年随访]

[One year follow-up of patients discharged from the emergency department with non-specific abdominal pain].

作者信息

Gunnarsson Omar Sigurvin, Birgisson Gudjon, Oddsdottir Margret, Gudbjartsson Tomas

机构信息

Læknadeild, Háskóla Íslands, Landspítala.

出版信息

Laeknabladid. 2011 Apr;97(4):231-6. doi: 10.17992/lbl.2011.04.363.

Abstract

OBJECTIVE

Non-specific abdominal pain (NSAP) is the most common diagnosis of patients presenting to emergency departments (ED) with abdominal pain. The aim of this retrospective study was to investigate how many NSAP patients were re-admitted within 1 year to the ED with abdominal pain.

MATERIAL AND METHODS

Included were all patients discharged with NSAP from adult EDs of Landspítali University Hospital (gynecology and pediatric EDs excluded), from January 1, 2005 to December 31, 2005. Hospital records for patients re-admitted within 12 months with abdominal pain were reviewed. Symptoms, pain location, blood tests and imaging results were registered, also the subsequent discharge diagnosis at re-admission.

RESULTS

Out of 62.116 patients attending the EDs in 2005, 1411 (2.3%) were diagnosed with NSAP. During 12 months, 112 of these 1411 patients (7.9%) were re-admitted to the ED with abdominal pain, most of them ≥2 times. Out of 112 patients, 27 (24.1%) were discharged with a more specific diagnosis; cholelithiasis (29.6%), appendicitis (18.5%) and gastrointestinal cancer (7.4%) being the most common diagnosis. The other 85 (76%) patients were diagnosed with NSAP again. Surgery was performed in 17 of the 27 (63%) cases and 8 received specific treatment, most often antibiotics.

CONCLUSION

Almost 8% of discharged NSAP patients were re-admitted within a year for abdominal pain. At re-admission, one of four patients received a more specific diagnosis, most often cholelithiasis or appendicitis. Our results suggest that the diagnosis of patients with NSAP, at the first visit to the ED, could be improved.

摘要

目的

非特异性腹痛(NSAP)是急诊科腹痛患者最常见的诊断结果。这项回顾性研究的目的是调查有多少NSAP患者在1年内因腹痛再次入院至急诊科。

材料与方法

纳入2005年1月1日至2005年12月31日从Landspítali大学医院成人急诊科出院的所有NSAP患者(排除妇产科和儿科急诊科)。对12个月内因腹痛再次入院患者的医院记录进行了审查。记录了症状、疼痛部位、血液检查和影像学检查结果,以及再次入院时的出院诊断。

结果

2005年到急诊科就诊的62116名患者中,1411名(2.3%)被诊断为NSAP。在12个月内,这1411名患者中有112名(7.9%)因腹痛再次入院至急诊科,其中大多数患者入院次数≥2次。在112名患者中,27名(24.1%)出院时诊断更为明确;最常见的诊断为胆结石(29.6%)、阑尾炎(18.5%)和胃肠道癌(7.4%)。其他85名(76%)患者再次被诊断为NSAP。27例中的17例(63%)进行了手术,8例接受了特定治疗,最常见的是抗生素治疗。

结论

近8%的NSAP出院患者在1年内因腹痛再次入院。再次入院时,四分之一的患者诊断更为明确,最常见的是胆结石或阑尾炎。我们的研究结果表明,首次就诊于急诊科的NSAP患者的诊断可以得到改善。

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