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Dolor abdominal en el servicio de urgencias: 50 años después

Moira E Smith¹, Noel R Mukubwa², Robert D Powers³

¹Department of Emergency Medicine, University of Virginia Heath System, Charlottesville, VA, United States of America.

The American journal of emergency medicine

|March 19, 2025

Objetivo:

Los pacientes con dolor abdominal en el Departamento de Emergencias (DE) continúan representando un desafío diagnóstico. Este estudio sobre demografía, evaluación y resultados ofrece una perspectiva de la estabilidad y el cambio a lo largo de un período de 50 años en una sola institución.

MéTodos:

El presente estudio es la cuarta versión de este ejercicio, marcando el 50.º aniversario del primer examen. Se revisaron las historias clínicas de 1000 pacientes adultos que acudieron a un servicio de urgencias de tercer nivel en 2022 con el motivo principal de dolor abdominal. Los datos extraídos incluyeron datos demográficos, diagnóstico, disposición y el uso de pruebas de imagen y de laboratorio. En la medida de lo posible, se realizó una comparación entre este estudio y los estudios anteriores.

Resultados:

Los resultados demostraron un aumento considerable en el uso de la tomografía computarizada (TC) (+69 %) y de la ecografía (+32 %), así como una reducción en las radiografías abdominales (-68 %) durante los últimos 15 años. Este patrón de incremento en el uso de imágenes estuvo acompañado de un tiempo de evaluación prolongado, una mayor estancia hospitalaria y cargos más elevados. Entre los hallazgos notables se incluyeron que la frecuencia de enfermedades quirúrgicas no detectadas se mantuvo baja en relación con 1972, pero hubo un cambio mínimo en el número de pacientes hospitalizados (~29 %).

Conclusiones:

Durante un periodo de 50 años, la evaluación del dolor abdominal en el servicio de urgencias se ha vuelto más eficaz para diagnosticar enfermedades quirúrgicas agudas, pero menos eficiente y más costosa. El porcentaje de pacientes hospitalizados se ha mantenido notablemente estable.

Palabras clave:

Dolor abdominal Pruebas diagnósticas

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