A four-year survey on unexpected pregnancy diagnoses in a large urban emergency department in Parma, Italy

Cervellin, Gianfranco; Comelli, Ivan; Sartori, Elena; Lippi, Giuseppe

doi:10.1016/j.ijgo.2014.04.006

Cited by 7 publications

(6 citation statements)

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“…Furthermore, our analysis suggests disproportional use of AED services by foreign people; this problem could be addressed by incentivizing the use of general practitioner services. Previous research [56] shows that the main reason behind the higher rates of AED utilization by foreign people is scarce knowledge about healthcare alternatives of the host country [31]. Consequently, to reduce the inappropriate use of AEDs by foreign people, it could be useful to help them understand the Italian healthcare system, through training and informative advertisements about the alternative services offered (i.e.…”

Section: Discussionmentioning

confidence: 99%

“…[30]) found foreign-born individuals to have a higher utilization rate (309.7 visits per 1000 inhabitants compared to 253.9 for native Italians) and foreign individuals seem to attend AED more often for low-acuity triage codes. In addition, interesting associations have been found between ethnicity and specific diagnosis; for example, Cervellin et al [31] found that women from Sub-Saharan Africa, especially Nigeria, record particularly high AED access rates for unexpected pregnancy, suggesting the need for information campaigns addressed toward certain vulnerable minority groups.…”

Section: Introductionmentioning

confidence: 99%

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Targeting frequent users of emergency departments: Prominent risk factors and policy implications

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Targeting frequent users of emergency departments: Prominent risk factors and policy implications

et al. 2016

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“…The differential diagnosis of AAP in the adult population is rather broad, including appendicitis, peptic ulcer, urinary stones, inflammatory bowel disease, hepatobiliary diseases (e.g., biliary colic, cholecystitis, and pancreatitis), referred pain due to pneumonia as well as several other "mimics" of extra-abdominal origin (9)(10)(11). In young women, gynecologic disorders (e.g., ectopic pregnancy, endometriosis, and pelvic inflammatory disease) are additional conditions which should be considered in the differential diagnosis (12)(13)(14). Since the underlying cause for AAP can entails many different medical specialties such as gynecology, surgery, internal medicine, and urology, expert assessment is an essential requisite that emergency physicians (EPs) should have for the managed care of these patients.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology and outcomes of acute abdominal pain in a large urban Emergency Department: retrospective analysis of 5,340 cases

et al. 2016

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Background: Acute abdominal pain (AAP) accounts for 7-10% of all Emergency Department (ED) visits.Nevertheless, the epidemiology of AAP in the ED is scarcely known. The aim of this study was to investigate the epidemiology and the outcomes of AAP in an adult population admitted to an urban ED. Methods:We made a retrospective analysis of all records of ED visits for AAP during the year 2014. All the patients with repeated ED admissions for AAP within 5 and 30 days were scrutinized. Five thousand three hundred and forty cases of AAP were analyzed.Results: The mean age was 49 years. The most frequent causes were nonspecific abdominal pain (NSAP) (31.46%), and renal colic (31.18%). Biliary colic/cholecystitis, and diverticulitis were more prevalent in patients aged >65 years (13.17% vs. 5.95%, and 7.28% vs. 2.47%, respectively). Appendicitis (i.e., 4.54% vs. 1.47%) and renal colic (34.48% vs. 20.84%) were more frequent in patients aged <65 years. NSAP was the most common cause in both age classes. Renal colic was the most frequent cause of ED admission in men, whereas NSAP was more prevalent in women. Urinary tract infection was higher in women. Overall, 885 patients (16.57%) were hospitalized. Four hundred and eighty-five patients had repeated ED visits throughout the study period. Among these, 302 patients (6.46%) were readmitted within 30 days, whereas 187 patients (3.82%) were readmitted within 5 days. Renal colic was the first cause for ED readmission, followed by NSAP. In 13 cases readmitted to the ED within 5 days, and in 16 cases readmitted between 5-30 days the diagnosis was changed.Conclusions: Our study showed that AAP represented 5.76% of total ED visits. Two conditions (i.e., NSAP and renal colic) represented >60% of all causes. A large use of active clinical observations during ED stay (52% of our patients) lead to a negligible percentage of changing diagnosis at the second visit.

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“…The differential diagnosis of acute abdominal pain in an adult population is rather broad, including appendicitis, peptic ulcer, urinary stone, inflammatory bowel disease, hepatobiliary disease (e.g., biliary colic, cholecystitis and pancreatitis), referred pain due to pneumonia, and several other diseases that mimic abdominal pain [16,17]. In young women, gynecologic disorders (e.g., ectopic pregnancy, endometriosis, and pelvic inflammatory disease) are additional conditions that should be considered in the differential diagnosis [18,19]. Since the underlying cause for acute flank pain may involve many different medical specialties, such as gynecology, general surgery, internal medicine, and urology, appropriate assessment is an essential requisite for the proper management and care of these patients.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and Outcomes of Acute Flank Pain in University-Affiliated Regional Emergency Medical Centers

Kim

Hwang

Park

et al. 2018

Urogenit Tract Infect

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Purpose: Acute abdominal pain accounts for 7-10% of all emergency department visits. The purpose of this study is to investigate the epidemiology and outcome of acute flank pain at regional emergency medical centers (EMC) and to investigate the necessity of urologists. Materials and Methods:We retrospectively reviewed all records of EMC visits for flank pain between 1 July 2015 and 30 June 2017. The renal colic was defined according to the code allocation of the Korean standard classification of disease-6 code N132, N200-N203, and N210-N211. The results of this study were retrospectively analyzed and the characteristics of the patients. Results: The total number of visits to the EMC was 67,792, and the number of visits for acute abdominal pain was 9,641. The number of visits for acute flank pain was 1,133 and the number of patients was 1,018. The departments included emergency medicine (n=235), urology (n=711), internal medicine (n=132), general surgery (n=19), gynecology (n=10), and others (n=26). The causes of urological flank pain were urolithiasis in 628 cases, infection in 41 cases, and other diseases in 42 cases. Among these, 244 cases were admitted, and 193 cases of them were urolithiasis patients, and 171 patients underwent stone removal surgery. Conclusions: According to our study, patients with flank pain accounted for 11.8% of patients with abdominal pain. However, considering hospitalization and frequency of surgery, it is necessary to take the national measurement for the long-term supply of urology. -63-859-1335, Fax: +82-63-842-7379 E-mail: mygentlelove@gmail.com Original Article Keywords: Renal colic; Epidemiology; Hospital emergency service INTRODUCTIONAcute abdominal pain, traditionally defined as a pain of non-traumatic origin with a maximum duration of 5 days [1], is one of the most common symptoms that causes people to visit the emergency center, making up approximately 7-10% of all emergency department (ED) visits [2]. Despite the relatively high incidence, abdominal pain may be a symptom of serious underlying diseases, and the challenging differential diagnosis may lead to medical litigation or undesirable outcomes [3,4].Despite substantial improvements in the diagnostic approach to acute abdominal pain, many diagnostic pitfalls remain due to the extensive use of imaging techniques (especially computed tomography [CT]), which can be associated with a substantial number of misdiagnoses and/or avoidable surgery [5,6]. Acute flank pain is the most common clinical symptom of urinary tract stones and is a common [7]. Furthermore, the lifetime recurrence rate has been estimated to be as high as 50% within 10 years of the initial urolithiasis episode [8]. Several previous studies have shown a worldwide trend toward an increasing prevalence of urolithiasis [9]. Proper assessment by the emergency physician is essential for the management of these patients, since the underlying cause of acute abdominal pain can involve a variety of medical specialties, including gynecology, general surgery, in...

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A four-year survey on unexpected pregnancy diagnoses in a large urban emergency department in Parma, Italy

Abstract: Unexpected pregnancy is a problem in the province of Parma, most notably among women from Sub-Saharan Africa. Efforts should be strengthened to provide more fragile groups with easily available family planning information.

Cited by 7 publications

References 20 publications

Targeting frequent users of emergency departments: Prominent risk factors and policy implications

Targeting frequent users of emergency departments: Prominent risk factors and policy implications

Epidemiology and outcomes of acute abdominal pain in a large urban Emergency Department: retrospective analysis of 5,340 cases

Epidemiology and Outcomes of Acute Flank Pain in University-Affiliated Regional Emergency Medical Centers

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