B-125 Laboratory Profiles for Diagnostic Workup of Acute Abdominal Pain in the Emergency Department: A Comparative Study of University and Non-University Acute Care Hospitals in Germany and Switzerland

Abstract

Abstract Background Laboratory medicine plays a fundamental role in patient care, especially in emergency departments where rapid diagnosis is critical to the efficient management of high patient volumes. With the aim of simplifying and standardizing laboratory requests, laboratory profiles have widely been established. This study uses the laboratory profile for “acute abdominal pain” as an example to illustrate the extent to which the laboratory profiles used in hospitals differ from each other and whether they are in line with current scientific recommendations. Methods Hospital data and laboratory profiles for “acute abdominal pain” from 18 hospitals, 9 from Germany and 9 from Switzerland, were analyzed and compared. The hospitals were distinguished by bed size, inpatient and outpatient case numbers, country affiliation and university level. In addition, an 'evidence-based laboratory profile' for acute abdominal pain was created based on current guidelines for the five most important causes of acute abdominal pain and compared with hospital laboratory profiles. Results German hospitals include significantly more laboratory parameters into acute abdominal pain profiles than Swiss hospitals (p = 0,0052). No significant differences in the number of laboratory parameters were found between university and non-university hospitals (p = 0,0507). There is a significant positive correlation between the hospital bed size and the number of laboratory parameters in the profiles (r = 0,5521). The number of inpatient cases in a hospital are also positively correlated with the number of laboratory parameters in the profiles (r = 0,4751). The number of outpatient cases ist not associated with the number of laboratory in the profiles parameters (r = 0,0599). The evidence-based laboratory profile for acute abdominal pain includes 21 laboratory parameters, but only two of them are collected by all investigated hospitals (bilirubin and ALAT).There were no significant differences in the fulfillment of the evidence-based laboratory profile between Germany and Switzerland, or between university or non-university status. Conclusions The study shows that there are quantitative and qualitative differences between the laboratory profiles for investigation of acute abdominal pain within the participating hospitals. In Germany and Switzerland there is no consensus on which analyses to include into a profile investigating acute abdominal pain. For increasing efficiency and accuracy of laboratory testing in in the diagnostic workup of acute abdominal pain it seems advisable to obtain consensus on what to reasonably include into a profile on a national or international level.