Characteristics, Interventions, and Outcomes for Patients Presenting to the Emergency Department With Abdominal Pain.

IF 3.2 3区医学 Q1 EMERGENCY MEDICINE

Academic Emergency Medicine Pub Date : 2025-08-05 DOI:10.1111/acem.70110

Summer Ghaith, Ronna L Campbell, Zachary Ginsberg, Megan McElhinny, Derick D Jones, Aidan F Mullan, Rachel A Lindor

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引用次数: 0

Abstract

Objective: We sought to characterize patients presenting to emergency departments (EDs) with abdominal pain and to validate risk categories defined by the Guidelines for Reasonable and Appropriate Care in the Emergency Department (GRACE-2) for low-risk recurrent abdominal pain.

Methods: We conducted a retrospective cohort study of patients presenting with abdominal pain between November 2019 and November 2023 across 21 EDs in Arizona, the Midwest, and Florida. Patients were categorized per GRACE-2 into recurrent and non-recurrent pain as well as low- and high-risk groups. Primary outcomes included 72-h returns and mortality at 30 and 90 days.

Results: The study included 162,494 visits (112,896 unique patients; median age 46 years; 61.2% female). Among these, 4.3% had low-risk recurrent abdominal pain. Patients with recurrent and non-recurrent low-risk pain had similar ED length of stay and discharge rates to each other, compared to patients with high-risk pain who had longer length of stay and lower discharge rates. At 30 days after the ED encounter, patients with low-risk recurrent abdominal pain had similar mortality to patients with low-risk non-recurrent pain (0.4% vs. 0.3%; adjusted RR = 1.31, 95% CI: 0.85-2.03), while they had significantly lower mortality than patients with high-risk recurrent abdominal pain (0.4% vs. 2.3; adjusted RR = 3.14, 95% CI: 2.02-4.89).

Conclusions: This study highlights the heterogeneity in patients presenting to the ED with abdominal pain. Among these patients, those with low-risk recurrent pain demonstrated similar lengths of stay, discharges, and mortality rates to those with low-risk non-recurrent pain and less favorable lengths of stay, discharges, and mortality rates compared to those with any high-risk features. These findings suggest that low- and high-risk features may be more useful than recurrent or non-recurrent pain in identifying patients who could benefit from more robust ED evaluations.

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急诊科腹痛患者的特征、干预措施和结果

目的：我们试图确定急诊科（ed）腹痛患者的特征，并验证《急诊科合理和适当护理指南》（GRACE-2）对低风险复发性腹痛的风险分类。方法：我们对亚利桑那州、中西部和佛罗里达州的21个急诊科的2019年11月至2023年11月期间出现腹痛的患者进行了一项回顾性队列研究。根据GRACE-2将患者分为复发性和非复发性疼痛以及低和高风险组。主要结局包括72小时的复发率和30天和90天的死亡率。结果：该研究包括162,494次就诊(112,896例独特患者；中位年龄46岁；61.2%的女性)。其中4.3%为低风险复发性腹痛。复发性和非复发性低风险疼痛患者的ED住院时间和出院率相似，而高风险疼痛患者的住院时间更长，出院率更低。在ED发生后30天，低风险复发性腹痛患者的死亡率与低风险非复发性疼痛患者相似(0.4% vs 0.3%；校正RR = 1.31, 95% CI: 0.85-2.03)，而死亡率明显低于高危复发性腹痛患者(0.4% vs. 2.3；调整后RR = 3.14, 95% CI: 2.02-4.89)。结论：本研究强调了以腹痛就诊的急诊科患者的异质性。在这些患者中，低风险复发性疼痛患者的住院时间、出院时间和死亡率与低风险非复发性疼痛患者相似，与具有任何高风险特征的患者相比，住院时间、出院时间和死亡率较低。这些发现表明，与复发性或非复发性疼痛相比，低风险和高风险特征可能更有助于确定哪些患者可以从更可靠的ED评估中获益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Academic Emergency Medicine 医学-急救医学

CiteScore

7.60

自引率

6.80%

发文量

207

审稿时长

3-8 weeks

期刊介绍： Academic Emergency Medicine (AEM) is the official monthly publication of the Society for Academic Emergency Medicine (SAEM) and publishes information relevant to the practice, educational advancements, and investigation of emergency medicine. It is the second-largest peer-reviewed scientific journal in the specialty of emergency medicine. The goal of AEM is to advance the science, education, and clinical practice of emergency medicine, to serve as a voice for the academic emergency medicine community, and to promote SAEM''s goals and objectives. Members and non-members worldwide depend on this journal for translational medicine relevant to emergency medicine, as well as for clinical news, case studies and more. Each issue contains information relevant to the research, educational advancements, and practice in emergency medicine. Subject matter is diverse, including preclinical studies, clinical topics, health policy, and educational methods. The research of SAEM members contributes significantly to the scientific content and development of the journal.