Abstract
Over a quarter of patients presenting with abdominal pain at emergency departments (EDs) are diagnosed with nonspecific abdominal pain (NSAP) at discharge. This study investigated the risk factors associated with return ED visits in Taiwanese patients with NSAP after discharge. We divided patients into two groups: the study group comprising patients with ED revisits after the index ED visit, and the control group comprising patients without revisits. During the study period, 10,341 patients discharged with the impression of NSAP after ED management. A regression analysis found that older age (OR [95%CI]: 1.007 [1.003–1.011], p = 0.004), male sex (OR [95%CI]: 1.307 [1.036–1.650], p = 0.024), and use of NSAIDs (OR [95%CI]: 1.563 [1.219–2.003], p < 0.001) and opioids (OR [95%CI]: 2.213 [1.643–2.930], p < 0.001) during the index visit were associated with increased return ED visits. Computed tomography (CT) scans (OR [95%CI]: 0.605 [0.390–0.937], p = 0.021) were associated with decreased ED returns, especially for those who were older than 60, who had an underlying disease, or who required pain control during the index ED visit.
Highlights
We investigated the characteristics and risk factors of return emergency departments (EDs) visits among patients presenting with nonspecific abdominal pain (NSAP) by dividing the patients into two comparison groups: the study group, composed of patients with return ED visits after the index ED visit; and the control group, composed of patients without revisits
We investigated the characteristics andwere risk factors of return amongofpatients presented with abdominal pain, and 10,341 discharged with ED
After adjusting for confounding factors in the multivariate regression analysis, we found that older age (OR [95%CI]: 1.007 [1.003–1.011], p = 0.004), male sex (OR (95%CI): 1.307 [1.036–1.650]; p = 0.024), and use of non-steroidal anti-inflammatory drugs (NSAIDs) (OR [95%CI]: 1.563 [1.219–2.003]; p < 0.001) or opioids (OR [95%CI]: 2.213 [1.643–2.930]; p < 0.001) during the index visit were associated with an increased rate of ED return visits within 14 days
Summary
Abdominal pain is the most common chief complaint among adult patients visiting emergency departments (EDs). Abdominal pain is the complaint behind 5 to 10% of ED visits annually and continues to pose great diagnostic challenges for emergency physicians due to its widely variable clinical manifestations and the large number of possible differential diagnoses [1,2,3]. Over a quarter of patients presenting with abdominal pain while visiting the ED were diagnosed with nonspecific abdominal pain (NSAP) at discharge [4,5]. One study pointed out that 4% of yearly ED return visits are for NSAP [9], and a study of 1411 patients discharged from the hospital with NSAP found that 8% of them were readmitted with abdominal pain within one year [10]
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