“Analysis of readmissions to the emergency department among patients presenting with abdominal pain”

Abstract

Background: Abdominal pain is one of the most common complaints among patients admitted to the Emergency Department (ED). Diagnosis and management of abdominal pain may be a challenge and there are patients who require admission to the ED more than once in a short period of time. Our purpose was to assess the incidence of readmissions among patients treated in the ED due to abdominal pain and to investigate the impact of readmission on the further course of treatment. Methods: We conducted a prospective observational study, which included patients admitted to the ED in one academic, teaching hospital presenting with non-traumatic abdominal pain in a three-month period. Analyzed factors included demographic data, details related to first and subsequent visits in the ED and the course of hospitalization. Results: Overall, 928 patients were included to the study and 101 (10.88%) patients were admitted to the ED more than once during three-month period. Patients visiting ED repeatedly were older (p = 0.03) and more likely to be hospitalized (p < 0.01) compared to single-visit patients. Patients during their subsequent visits spent more time in the ED (p = 0.01), had greater chance to repeat their appointment (p = 0.04), be admitted to the hospital (p < 0.01) and were more likely diagnosed with cholelithiasis (p = 0.03) compared to patients on their initial visit. If admitted to the surgical department they were also more often qualified for surgical procedure than patients on their first visit (p < 0.01). In a group of patients admitted to the surgical department there were no significant differences in rates of conversion, postoperative complications and mortality between subgroups. Conclusions: Readmissions among patients presenting with abdominal pain are a common phenomenon with prevalence of 10.88%. They are most commonly associated with cholelithiasis and occur more frequently among older patients, which suggests, that elderly require more attention during ED managements.

A retrospective study of patients complaining of nontraumatic acute abdominal pain, admitted in the emergency department of an urban hospital in China

“…Our study showed that young and female patients complaining of AAP had higher rates of admission to the ED than elderly and male patients, a similar conclusion as was found in a previous study. [3,6] However, in different studies, the prevalence of AAP in each age group was different. In our ED, the 2 largest age groups were 20–29 and 30–39 years.…”

“…The 2 main causes of AAP were NSAP and renal colic that accounted for almost half of the admissions. In a recent study concerning NSAP, it accounted for 52.59% of all the diagnoses in the ED of an academic center (tertiary referral level) [6] and 36.0% of all the diagnoses in the ED of Sant’Orsola, Malpighi University Hospital of Bologna, Italy. [10] This may be due to the different medical systems in various countries.…”

Upstreamist leaders: how risk factors for unscheduled return visits (URV) to the emergency department can inform integrated healthcare

“…Hayward et al in Australia found that a key risk factor for URV were those patients presenting with gastrointestinal symptoms and abdominal pain. Abdominal pain was the focus of a research study in Poland (Kacprzyk, 2020), where diagnosis and management of abdominal pain was reported as a challenge with 10.88% of patients returning as a URV. Abdominal pain was the most common clinical complaint in the Singapore study (Soh et al , 2019).…”

Analgesic Treatment and the Patients’ Opinion on the Hospital Emergency Department

“…As a result, emergency medicine physicians often need to use multimodal methods to achieve safe and effective pain control [6]. Despite the growing number of patients, it is important to maintain the highest quality of care [7]. Patient satisfaction may be an indicator of the quality of services provided in the emergency department [8].…”