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One-Month Follow-Up of Patients with Unspecified Abdominal Pain Referring to the Emergency Department; a Cohort Study

Seyed Mohammad Hoseininejad, Reza Jahed, Mohammad Sazgar1

  • 1Emergency Department, Mazandaran University of Medical Sciences, Sari, Iran.

Archives of Academic Emergency Medicine
|October 12, 2019
PubMed

Insights

Many patients with abdominal pain leave the emergency department (ED) without a diagnosis. A one-month follow-up revealed that older age, leukocytosis, and outpatient visits improve diagnostic outcomes for unspecified abdominal pain.

Area of Science:

  • Gastroenterology
  • Emergency Medicine
  • Internal Medicine

Background:

  • A significant proportion of emergency department (ED) visits for abdominal pain result in discharge without a definitive diagnosis.
  • Unspecified abdominal pain presents a diagnostic challenge, impacting patient outcomes and healthcare resource utilization.

Purpose of the Study:

  • To investigate the one-month clinical outcomes of patients presenting to the ED with unspecified abdominal pain.
  • To identify factors associated with establishing a clear diagnosis in patients initially discharged with undiagnosed abdominal pain.

Main Methods:

  • A prospective cohort study involving patients evaluated for unspecified abdominal pain in the ED and followed for one month.
  • Patients were categorized into groups with a clear or unclear cause of abdominal pain at follow-up, and their characteristics were compared.

Main Results:

  • After one month, 44.7% of patients still experienced abdominal pain, and a definitive diagnosis was established in 58.7% of cases.
  • Significant differences between groups were observed in pain location, age, and history of comorbid diseases.
  • Leukocytosis (OR: 5.92), older age (OR: 2.78), and outpatient follow-up (OR: 1.04) were predictive factors for establishing a clear diagnosis.

Conclusions:

  • Nearly 40% of patients discharged with unspecified abdominal pain remain undiagnosed after one month.
  • Initial leukocytosis, older age, and consistent outpatient follow-up are key indicators for achieving a diagnosis in these patients.
Abstract

Keywords:
Abdominal painemergency servicefollow-up studieshospitalpatient discharge

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