Shinde Varsha, Dixit Yash, Penmetsa Pranay, Nair Karthik R
Emergency Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Center, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.
Cureus. 2024 Aug 16;16(8):e67017. doi: 10.7759/cureus.67017. eCollection 2024 Aug.
Acute abdomen is a common and urgent clinical condition requiring prompt diagnosis and treatment. This study determines the clinical and epidemiological profile of patients presenting with acute abdomen at a tertiary care hospital.
To describe the demographic characteristics, provisional diagnoses, treatment modalities, and pain management effectiveness in patients with acute abdomen.
This prospective observational study was conducted in the Emergency Medicine department at Dr. D. Y. Patil Medical College, Hospital & Research Center, Pimpri, Pune, over a specified period. The study included patients presenting with acute abdomen, aged above 14 years, excluding those with traumatic acute abdomen and pregnant patients. A sample size of 146 was calculated based on the proportion of ureteric colic cases, with a 95% confidence interval and a 6% margin of error; however, a total of 176 patients were included in the study. Data collection involved recording demographic details, clinical features, provisional diagnoses, and pain scores, as well as performing required blood investigations and ultrasonography. Pain scores were assessed before and after treatment. Patients will be given non-steroidal anti-inflammatory drugs (NSAIDs) or opioid analgesia, depending on the clinical severity. Emergency medicine residents, in consultation with the on-call consultant, determined the disposition of patients, deciding if they required surgical or conservative management.
The study found that the majority of patients, n = 130 (73.86%), were aged 26-50 years, with cases n = 103 (58.52%) being males and cases n = 73 (41.48%) females. Acute appendicitis was the most common diagnosis, n = 41 (24.43%), followed by urolithiasis n = 33 (18.75%). Surgical interventions were required for n = 78 (45.08%) of patients, highlighting the urgent nature of these conditions. Pain management was effective, with significant reductions in pain scores post-treatment (mean visual analog score (VAS) decreased from 6.22 to 2.33, and mean numerical rating score (NRS) from 6.05 to 2.10; p < 0.001).
The study underscores the high prevalence of gastrointestinal and renal conditions in patients with acute abdomen, particularly in middle-aged adults. The high rate of surgical interventions reflects the urgent nature of these conditions. Significant reductions in pain scores demonstrated effective pain management. Comprehensive care strategies are essential for optimizing patient outcomes. Future research with larger sample sizes and multi-center participation is recommended to validate these findings and enhance management protocols for acute abdomen.
急腹症是一种常见且紧急的临床病症，需要及时诊断和治疗。本研究确定了一家三级护理医院中急腹症患者的临床和流行病学特征。
描述急腹症患者的人口统计学特征、初步诊断、治疗方式及疼痛管理效果。
这项前瞻性观察性研究在浦那皮姆普里的 D.Y.帕蒂尔医学院、医院及研究中心的急诊科进行，为期特定时间段。研究纳入年龄在 14 岁以上的急腹症患者，排除创伤性急腹症患者和孕妇。根据输尿管绞痛病例的比例计算样本量为 146，置信区间为 95%，误差幅度为 6%；然而，该研究共纳入了 176 名患者。数据收集包括记录人口统计学细节、临床特征、初步诊断和疼痛评分，以及进行所需的血液检查和超声检查。在治疗前后评估疼痛评分。根据临床严重程度，给予患者非甾体抗炎药（NSAIDs）或阿片类镇痛药。急诊医学住院医师与值班顾问协商后确定患者的处置方式，决定他们是否需要手术或保守治疗。
研究发现，大多数患者（n = 130，73.86%）年龄在 26 - 50 岁之间，其中男性患者 n = 103（58.52%），女性患者 n = 73（41.48%）。急性阑尾炎是最常见的诊断，n = 41（24.43%），其次是尿路结石 n = 33（18.75%）。78 名（45.08%）患者需要手术干预，突出了这些病症的紧迫性。疼痛管理有效，治疗后疼痛评分显著降低（平均视觉模拟评分（VAS）从 6.22 降至 2.33，平均数字评分（NRS）从 6.05 降至 2.10；p < 0.001）。
该研究强调了急腹症患者中胃肠道和肾脏疾病的高患病率，尤其是在中年成年人中。手术干预的高比例反映了这些病症的紧迫性。疼痛评分的显著降低表明疼痛管理有效。全面的护理策略对于优化患者预后至关重要。建议未来进行更大样本量和多中心参与的研究，以验证这些发现并完善急腹症的管理方案。
