Abstract
BackgroundObstetric and gynecological (OBGY) diseases are among the most important differential diagnoses for young women with acute abdominal pain. However, there are few established clinical prediction rules for screening OBGY diseases in emergency departments (EDs). This study aimed to develop a prediction model for diagnosing OBGY diseases in the ED.MethodsThis single-center retrospective cohort study included female patients with acute abdominal pain who presented to our ED. We developed a logistic regression model for predicting OBGY diseases and assessed its diagnostic ability. This study included young female patients aged between 16 and 49 years who had abdominal pain and were examined at the ED between April 2017 and March 2018. Trauma patients and patients who were referred from other hospitals or from the OBGY department of our hospital were excluded.ResultsOut of 27,991 patients, 740 were included. Sixty-five patients were diagnosed with OBGY diseases (8.8%). The “POP” scoring system (past history of OBGY diseases + 1, no other symptoms + 1, and peritoneal irritation signs + 1) was developed. Cut-off values set between 0 and 1 points, sensitivity at 0.97, specificity at 0.39, and negative likelihood ratio (LR-) of 0.1 (95% CI: 0.02–0.31) were considered to rule-out, while cut-off values set between 2 and 3 points, sensitivity at 0.23 (95% CI 0.13–0.33), specificity at 0.99 (95% CI 0.98–1.00), and positive likelihood ratio (LR+) of 17.30 (95% CI: 7.88–37.99) were considered to rule-in.ConclusionsOur “POP” scoring system may be useful for screening OBGY diseases in the ED. Further research is necessary to assess the predictive performance and external validity of different data sets.
Highlights
Obstetric and gynecological (OBGY) diseases are among the most important differential diagnoses for young women with acute abdominal pain
Patient characteristics Among the 27,991 patients presented to the Emergency department (ED), 894 young female patients had acute abdominal pain
We excluded 112 patients who directly consulted an OBGY physician, 25 patients who were referred from another hospital, 12 patients with trauma, and 5 patients who were referred from the OBGY department in our hospital
Summary
Obstetric and gynecological (OBGY) diseases are among the most important differential diagnoses for young women with acute abdominal pain. In young women with abdominal pain, obstetric and gynecological (OBGY) diseases, such as ectopic pregnancy, represent two of the most important differential diagnoses. This is because a delayed diagnosis can be life-threatening, affect the reproductive function, and decline the quality of life [1, 2]. A diagnosis of OBGY diseases requires vaginal examinations and pelvic or transvaginal ultrasonography by trained specialists such as OBGY physicians [3, 4]. There are few established clinical prediction rules for screening emergency OBGY disease in the ED
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