de Dombal F T
Clinical Information Science Unit, University of Leeds, United Kingdom.
J Clin Gastroenterol. 1994 Dec;19(4):331-5. doi: 10.1097/00004836-199412000-00016.
In this article, I review the diagnosis and immediate prognosis of acute abdominal pain in elderly patients. I draw on published work and on three major series of patients, one collected since 1976 by the World Organization of Gastroenterology (OMGE) Research Committee, one by the 1986 United Kingdom National Study of Human and Computer-Aided Diagnosis, and one by the European Community 1993 Concerted Action on Acute Abdominal Pain. These series include approximately 42,000 patients. Acute abdominal pain in the elderly patient presents a significant and challenging problem. Diagnostic accuracy is lower, and mortality far higher, than in younger patients. Reasons for these differences are multifactorial: the case mix is different, the evolution and prognosis of specific diseases are different, and the ways in which diseases present are also different in elderly patients. It is not difficult therefore to understand why serious problems in management occur. I conclude by discussing implications of existing studies and the literature that--if implemented--should significantly improve both management resource utilization and patient outcome.
在本文中，我回顾了老年患者急性腹痛的诊断及近期预后情况。我借鉴了已发表的研究成果以及三个主要的患者系列研究，其中一个是自1976年以来由世界胃肠病学组织（OMGE）研究委员会收集的，一个是1986年英国人类与计算机辅助诊断国家研究的结果，还有一个是欧洲共同体1993年关于急性腹痛的协同行动的研究结果。这些系列研究涵盖了约42,000名患者。老年患者的急性腹痛是一个重大且具有挑战性的问题。与年轻患者相比，其诊断准确性较低，死亡率则高得多。造成这些差异的原因是多方面的：病例组合不同，特定疾病的发展和预后不同，而且老年患者疾病的呈现方式也不同。因此，不难理解为何在管理方面会出现严重问题。最后，我将讨论现有研究及文献的启示，若将这些启示付诸实践，应能显著提高管理资源的利用效率以及患者的治疗效果。
