ABDOMINAL-PAIN IN THE ED - STABILITY AND CHANGE OVER 20 YEARS
ABDOMINAL-PAIN IN THE ED - STABILITY AND CHANGE OVER 20 YEARS
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DOI：
10.1016/0735-6757(95)90204-x
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发表时间：
1995-05-01
影响因子：
3.6
通讯作者：
GUERTLER, AT
中科院分区：
文献类型：
--
作者：
POWERS, RD;GUERTLER, AT
腹痛(AP)是急诊科(ED)患者的常见主诉，1972年的一项研究报告称，大学医院急诊科无人监护的外科住院医生在1000名AP患者中有41%无法做出具体诊断。在此期间，急诊科诊断技术的可获得性增加，参考医院获得了全职急救医学(EM)教师。为了评估AP的评估和流行病学发生了什么变化，在同一家医院进行了一项类似的研究。这项研究的设计是对1993年在58,000人次的公立I级创伤中心看到的1,000名连续的ED患者AP的记录进行回顾，患有AP的ED患者的百分比(4%到5%)没有变化。住院次数由1972年的27.4%下降到1993年的18.3%，诊断的特异性明显提高，1993年诊断为未分化性腹痛(UDAP)的仅占24.9%。1972年有8例漏诊阑尾炎，1993年无一例漏诊。1例1993年急性胆囊炎患者最初误诊为UDAP。科技的进步和EM教员的存在与大学医院急诊室AP患者诊断准确率的提高有时间上的联系。与20年前相比，需要住院的患者更少，更多的人被指定为特定的诊断，漏诊的手术疾病的气体也更少。版权所有(C)1995，由W.B.Saunders公司
Abdominal pain (AP) is a common presenting complaint in emergency department (ED) patients, A 1972 study reported that unsupervised surgical residents in a university hospital ED were unable to make a specific diagnosis in 41% of 1,000 AP patients. In the intervening time, ED availability of diagnostic technology has increased, and the reference hospital acquired full-time emergency medicine (EM) faculty. To assess what changes occurred in the evaluation and epidemiology of AP, a similar study was done at the same hospital. The study design was a review of records of 1,000 consecutive ED patients with AP seen in 1993 at a 58,000-visit public Level I trauma center ED, The percentage of ED patients (4% to 5%) with AP was unchanged. Frequency of hospital admission dropped from 27.4% (1972) to 18.3% (1993), There was marked increase in the specificity of diagnoses, with only 24.9% in 1993 diagnosed as undifferentiated abdominal pain (UDAP). There were eight cases of missed appendicitis in 1972 and none in 1993, One 1993 patient with acute cholecystitis was initially misdiagnosed as having UDAP. Advances in technology and EM faculty presence were temporally associated with improved diagnostic accuracy in patients with AP in a university hospital ED. As compared with 20 years ago, fewer patients required hospitalization, more were assigned a specific diagnosis, and there were fewer Gases of missed surgical disease. Copyright (C) 1995 by W.B. Saunders Company