Predicting factors of Revisits within 48 hours after diagnosis of abdominal pain in emergency department
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Abstract
Background Abdominal pain is a common complaint among patients revisiting the emergency department. The revisits can result in delayed diagnosis, delayed treatment, and some patients may require emergency surgery, leading to a higher risk of complications, increased length of hospital stay, and increased expenditure.
Objective: To determine the predictive factors for revisits within 48 hours after the diagnosis of abdominal pain in the emergency department and to determine the treatment outcomes for revisiting patients within 48 hours, including the length of hospital stay and the need for emergency surgery.
Methods This retrospective case-control study analyzed data collected from medical records at Chiangrai Prachanukroh Hospital from October 1, 2020, to March 30, 2022. The data were analyzed using Fisher’s exact test, t-test, and logistic regression analysis.
Results The study included 318 patients with abdominal pain, of which 96 experienced revisits within 48 hours, while 222 were discharged home without revisits. Significant predictive factors for revisits within 48 hours after the diagnosis of abdominal pain in the emergency department (p < 0.05) included ages below 30 years (Adjusted odds ratio 3.95), ages between 46 and 60 years (Adjusted odds ratio 5.54), ages over 60 years (Adjusted odds ratio 3.86), the presence of dysuria (Adjusted odds ratio 4.24), initial diagnosis of enteritis (Adjusted odds ratio 9.23), gynecological diseases (Adjusted odds ratio 9.16), urinary tract stones (Adjusted odds ratio 16.44), and not undergoing laboratory investigations during the initial visit (Adjusted odds ratio 2.48). The treatment outcomes for revisiting patients within 48 hours with abdominal pain showed that 32.29% were admitted, and 17.71% required emergency surgery.
Conclusions and Recommendations Factors influencing revisits within 48 hours after the diagnosis of abdominal pain in the emergency department were aged below 30 years old, aged over 45 years old, dysuria, initial diagnosis of enteritis, gynecological diseases, urinary tract stones, and not undergoing laboratory investigations during the first visit. The results of this study can inform the development of a treatment protocol for patients with abdominal pain in the emergency room, potentially aiding in reducing revisit rates.
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