J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 9, Number 12, December 2017, pages 987-993

Acute Abdominal Pain Assessment in the Emergency Department: The Experience of a Greek University Hospital

**Table 1.** Vital Signs, Pain Intensity, Other Symptoms, Physical Findings, Radiologic Studies and Surgical Consultation in Patients Admitted vs. Patients Not Admitted to the Hospital
	Admitted (n = 47)	Not admitted (n = 78)	P value
Due to multiple comparisons, only P values 0.05/16, therefore P < 0.0031 are considered significant.
Systolic arterial pressure	132.3 ± 22.3	128.4 ± 20.6	0.319
Diastolic arterial pressure	73.2 ± 13.0	128.4 ± 20.6	0.813
Temperature	36.8 ± 0.7	36.5 ± 0.5	0.015
Pain intensity			0.018
Mild (n = 17)	4 (8.5%)	13 (16.7%)
Moderate (n = 56)	17 (36.2%)	39 (50.0%)
Severe (n = 52)	26 (55.3%)	26 (33.3%)
Murphy sign (n = 10)	7 (14.9%)	3 (3.8%)	0.041
McBurney sign (n = 13)	11 (23.4%)	2 (2.6%)	0.001
Rebound tenderness (n = 18)	16 (34.0%)	2 (2.6%)	0.001
Vomiting (n = 41)	23 (48.9%)	18 (23.1%)	0.003
Fever (n = 23)	17 (36.2%)	6 (7.7%)	0.001
Tachycardia (n = 9)	7 (14.9%)	2 (2.5%)	0.026
Surgical consultation (n = 47)	31 (65.9%)	16 (20.5%)	0.001
Chest X-ray (n = 84)	42 (89.4%)	42 (63.8%)	0.001
Abdomen X-ray (n = 75)	33 (70.2%)	42 (63.8%)	0.070
US abdomen (n = 58)	27 (57.4%)	31 (39.7%)	0.055
CAT abdomen (n = 21)	15 (31.9%)	6 (7.7%)	0.001
Image findings (n = 58)	35 (77.5%)	23 (29.5%)	0.001

Table 1. Vital Signs, Pain Intensity, Other Symptoms, Physical Findings, Radiologic Studies and Surgical Consultation in Patients Admitted vs. Patients Not Admitted to the Hospital

Admitted (n = 47)

Not admitted (n = 78)

P value

Due to multiple comparisons, only P values 0.05/16, therefore P < 0.0031 are considered significant.

Systolic arterial pressure

132.3 ± 22.3

128.4 ± 20.6

0.319

Diastolic arterial pressure

73.2 ± 13.0

128.4 ± 20.6

0.813

Temperature

36.8 ± 0.7

36.5 ± 0.5

0.015

Pain intensity

0.018

Mild (n = 17)

4 (8.5%)

13 (16.7%)

Moderate (n = 56)

17 (36.2%)

39 (50.0%)

Severe (n = 52)

26 (55.3%)

26 (33.3%)

Murphy sign (n = 10)

7 (14.9%)

3 (3.8%)

0.041

McBurney sign (n = 13)

11 (23.4%)

2 (2.6%)

0.001

Rebound tenderness (n = 18)

16 (34.0%)

2 (2.6%)

0.001

Vomiting (n = 41)

23 (48.9%)

18 (23.1%)

0.003

Fever (n = 23)

17 (36.2%)

6 (7.7%)

0.001

Tachycardia (n = 9)

7 (14.9%)

2 (2.5%)

0.026

Surgical consultation (n = 47)

31 (65.9%)

16 (20.5%)

0.001

Chest X-ray (n = 84)

42 (89.4%)

42 (63.8%)

0.001

Abdomen X-ray (n = 75)

33 (70.2%)

42 (63.8%)

0.070

US abdomen (n = 58)

27 (57.4%)

31 (39.7%)

0.055

CAT abdomen (n = 21)

15 (31.9%)

6 (7.7%)

0.001

Image findings (n = 58)

35 (77.5%)

23 (29.5%)

0.001

**Table 2.** Laboratory Findings in Patients Admitted vs. Patients Not Admitted to the Hospital
Variable	Admitted (n = 47)	Not admitted (n = 78)	P value
WBCs: white blood cells; INR: international normalized ratio; PTT: partial thromboplastin time; SGOT: serum glutamic oxaloacetic transaminase; SGPT: serum glutamic pyruvic transaminase; LDH: lactate dehydrogenase; CRP: C-reactive protein; RBCs: red blood cells. All values are reported as mean ± SD. Due to multiple comparisons, only P values < 0.05/21, therefore P < 0.0023 are considered significant.
WBCs	14,193 ± 6,182	9,641 ± 2,883	0.001
Neutrophils	79.99 ± 9.21	67.72 ± 12.57	0.001
Lymphocytes	13.08 ± 7.28	24.19 ± 10.87	0.001
Mononuclear cells	5.76 ± 2.49	5.86 ± 2.04	0.810
Platelets	238.9 ± 69.1	246.9 ± 51.9	0.474
Hemoglobin	13.4 ± 1.8	13.3 ± 1.3	0.786
Hematocrit	39.3 ± 4.6	38.9 ± 3.4	0.501
INR	1.24 ± 1.08	1.04 ± 0.09	0.166
PTT	34.43 ± 4.32	34.58 ± 3.56	0.844
Serum sodium	138.2 ± 3.6	138.9 ± 2.4	0.276
Serum potassium	4.2 ± 0.5	4.2 ± 0.6	0.990
Serum calcium	9.62 ± 0.78	9.74 ± 0.50	0.388
Serum glucose	132.0 ± 65.4	103.8 ± 25.2	0.019
Serum creatinine	1.09 ± 0.81	0.88 ± 0.21	0.074
SGOT	29.3 ± 35.7	25.8 ± 38.2	0.612
SGPT	25.5 ± 24.5	26.7 ± 57.8	0.896
LDH	210.3 ± 119.9	202.1 ± 59.9	0.650
Amylase	192.0 ± 674.6	56.7 ± 26.3	0.212
CRP	5.57 ± 7.83	0.93 ± 1.91	0.001
Urine WBC	16.7 ± 30.8	10.3 ± 24.4	0.279
Urine RBCs	10.5 ± 22.9	11.0 ± 24.3	0.919

Table 2. Laboratory Findings in Patients Admitted vs. Patients Not Admitted to the Hospital

Variable

Admitted (n = 47)

Not admitted (n = 78)

P value

WBCs: white blood cells; INR: international normalized ratio; PTT: partial thromboplastin time; SGOT: serum glutamic oxaloacetic transaminase; SGPT: serum glutamic pyruvic transaminase; LDH: lactate dehydrogenase; CRP: C-reactive protein; RBCs: red blood cells. All values are reported as mean ± SD. Due to multiple comparisons, only P values < 0.05/21, therefore P < 0.0023 are considered significant.

WBCs

14,193 ± 6,182

9,641 ± 2,883

0.001

Neutrophils

79.99 ± 9.21

67.72 ± 12.57

0.001

Lymphocytes

13.08 ± 7.28

24.19 ± 10.87

0.001

Mononuclear cells

5.76 ± 2.49

5.86 ± 2.04

0.810

Platelets

238.9 ± 69.1

246.9 ± 51.9

0.474

Hemoglobin

13.4 ± 1.8

13.3 ± 1.3

0.786

Hematocrit

39.3 ± 4.6

38.9 ± 3.4

0.501

INR

1.24 ± 1.08

1.04 ± 0.09

0.166

PTT

34.43 ± 4.32

34.58 ± 3.56

0.844

Serum sodium

138.2 ± 3.6

138.9 ± 2.4

0.276

Serum potassium

4.2 ± 0.5

4.2 ± 0.6

0.990

Serum calcium

9.62 ± 0.78

9.74 ± 0.50

0.388

Serum glucose

132.0 ± 65.4

103.8 ± 25.2

0.019

Serum creatinine

1.09 ± 0.81

0.88 ± 0.21

0.074

SGOT

29.3 ± 35.7

25.8 ± 38.2

0.612

SGPT

25.5 ± 24.5

26.7 ± 57.8

0.896

LDH

210.3 ± 119.9

202.1 ± 59.9

0.650

Amylase

192.0 ± 674.6

56.7 ± 26.3

0.212

CRP

5.57 ± 7.83

0.93 ± 1.91

0.001

Urine WBC

16.7 ± 30.8

10.3 ± 24.4

0.279

Urine RBCs

10.5 ± 22.9

11.0 ± 24.3

0.919

**Table 3.** Diagnosis After Emergency Department Assessment
Diagnosis	Cases (%)	Admitted (n=47)	Not admitted (n=78)	P
GI: gastrointestinal; GERD: gastroesophageal reflux disease; ED: emergency department.
Gastroenteritis	16 (12.8)	5	11	0.783
Gastritis/gastric/duodenal ulcer	15 (12.0)	1	14	0.009
Appendicitis	9 (7.2)	9	0	0.001
Gastrointestinal perforation	3 (2.4)	3	0	0.051
Diverticulitis	6 (4.8)	4	2	0.196
Urinary tract infection	6 (4.8)	2	4	0.825
Ileus	4 (3.2)	3	1	0.148
Gynecological diagnosis	6 (4.8)	3	3	0.671
Musculoskeletal pain	4 (3.2)	0	4	0.296
Nephrolithiasis/colic	7 (5.6)	1	6	0.253
Constipation	4 (3.2)	0	4	0.296
Irritable bowel syndrome	7 (5.6)	0	7	0.044
Cholelithiasis/colic	7 (5.6)	2	5	0.709
Pancreatitis	3 (2.4)	3	0	0.051
Abdominal bloating	2 (1.6)	0	2	0.519
Cholecystitis	3 (2.4)	3	0	0.051
Pulmonary embolism	1 (0.8)	1	0	0.376
GI bleeding	1 (0.8)	1	0	0.376
Peritoneal metastases	1 (0.8)	1	0	0.376
Porcelain gallbladder	1 (0.8)	0	1	1.000
GERD/esophagitis	1 (0.8)	0	1	1.000
Peritonitis	1 (0.8)	1	0	0.376
No final ED diagnosis	17 (13.6)	4	13	0.282

Table 3. Diagnosis After Emergency Department Assessment

Diagnosis

Cases (%)

Admitted (n=47)

Not admitted (n=78)

GI: gastrointestinal; GERD: gastroesophageal reflux disease; ED: emergency department.

Gastroenteritis

16 (12.8)

0.783

Gastritis/gastric/duodenal ulcer

15 (12.0)

0.009

Appendicitis

9 (7.2)

0.001

Gastrointestinal perforation

3 (2.4)

0.051

Diverticulitis

6 (4.8)

0.196

Urinary tract infection

6 (4.8)

0.825

Ileus

4 (3.2)

0.148

Gynecological diagnosis

6 (4.8)

0.671

Musculoskeletal pain

4 (3.2)

0.296

Nephrolithiasis/colic

7 (5.6)

0.253

Constipation

4 (3.2)

0.296

Irritable bowel syndrome

7 (5.6)

0.044

Cholelithiasis/colic

7 (5.6)

0.709

Pancreatitis

3 (2.4)

0.051

Abdominal bloating

2 (1.6)

0.519

Cholecystitis

3 (2.4)

0.051

Pulmonary embolism

1 (0.8)

0.376

GI bleeding

1 (0.8)

0.376

Peritoneal metastases

1 (0.8)

0.376

Porcelain gallbladder

1 (0.8)

1.000

GERD/esophagitis

1 (0.8)

1.000

Peritonitis

1 (0.8)

0.376

No final ED diagnosis

17 (13.6)

0.282