Henden Çam Pınar, Baydin Ahmet, Yürüker Savaş, Erenler Ali Kemal, Şengüldür Erdinç
Ondokuz Mayıs University, Department of Emergency Medicine, Samsun, Turkey.
Ondokuz Mayıs University, Department of General Surgery, Samsun, Turkey.
Curr Gerontol Geriatr Res. 2018 May 30;2018:9109326. doi: 10.1155/2018/9109326. eCollection 2018.
The aim of this study is to detect the possible reasons of abdominal pain in the patients aged 65 and older admitted to emergency department (ED) with complaint of abdominal pain which is not related to trauma, to determine the length of hospitalization of old (65-75 age) and elderly (aged 75 and older) patients, and to define the hospitalization and mortality rates.
In the study, 336 patients were included. Groups were compared in respect to gender, internal or surgical prediagnoses, complaints accompanying abdominal pain, vital findings, comorbidities, requested consultations, hospitalizing service, waiting time in the ED and in the hospital, and treatment methods.
Of the patients, 48.2% were male, and 51.8% were female. While 52.4% of the patients were in 65-74 age group, 47.6% of them were aged 75 years and above. An internal disease was detected in 76.8% of the patients as an origin of abdominal pain. Most common prediagnoses were biliary diseases and diseases related to biliary tract followed by nonspecific abdominal pain, abdominal pain secondary to malignity, ileus, and acute gastroenteritis, respectively. The most frequent finding accompanying abdominal pain was vomiting. The most frequent chronic disease accompanying abdominal pain was hypertension in both age groups. We observed that 75.9% of the patients required consultation. We detected that 48.8% of the patients with abdominal pain were hospitalized and they were hospitalized mostly by gastroenterology ward (24.8%). Surgical treatments were applied to the 17.6% of the patients with abdominal pain.
Clinical findings become indistinct by age, and differential diagnosis of abdominal pain gets more difficult in geriatric patients. Therefore, physicians should consider age related physiological changes in order to distinguish geriatric patients admitted to emergency service with abdominal pain from pathological cases requiring immediate surgical operation.
本研究旨在探寻65岁及以上因非创伤性腹痛主诉入住急诊科（ED）患者腹痛的可能原因，确定老年（65 - 75岁）和高龄（75岁及以上）患者的住院时长，并明确住院率和死亡率。
本研究纳入336例患者。比较了各组患者的性别、内科或外科预诊断、腹痛伴随症状、生命体征、合并症、会诊需求、住院科室、在急诊科和医院的等待时间以及治疗方法。
患者中，48.2%为男性，51.8%为女性。52.4%的患者年龄在65 - 74岁组，47.6%的患者年龄在75岁及以上。76.8%的患者被检测出内科疾病是腹痛的病因。最常见的预诊断依次为胆道疾病和与胆道相关的疾病，其次是非特异性腹痛、恶性肿瘤继发腹痛、肠梗阻和急性肠胃炎。腹痛最常见的伴随症状是呕吐。两个年龄组中，腹痛最常见的慢性病都是高血压。我们观察到75.9%的患者需要会诊。我们发现48.8%的腹痛患者住院，他们大多入住消化内科病房（24.8%）。17.6%的腹痛患者接受了外科治疗。
随着年龄增长，临床表现变得不清晰，老年患者腹痛的鉴别诊断更加困难。因此，医生应考虑与年龄相关的生理变化，以便将因腹痛入住急诊科的老年患者与需要立即手术的病理病例区分开来。
