J Korean Soc Emerg Med.  2005 Dec;16(6):640-645.

Acute Nontraumatic Abdominal Pain in Elderly Patients: Impact of Abdominal CT Evaluation

• Kim H
• Kim JH
• Kim JS
• Hong DY
• Han SB
• Lee HJ

Abstract

PURPOSE
The purpose of this study is to document the impact of computed tomography (CT) performed in the emergency department on elderly patients presenting with nontraumatic acute abdominal pain.
METHODS
Forty patients were enrolled in this prospective study. Using a structured data collection instrument recording three primary endpoints before and after CT, emergency physicians were required to report their most likely diagnoses, levels of diagnostic certainty, and the treatment plans for their patients. The changes in the frequencies of each of these three endpoints from pre- to post-CT comprised the target variables.
RESULTS
CT altered the treatment plan in 42.5% of the 40 patients, altered the clinical diagnosis in 40% of patients, and increased the diagnostic certainty in 57.5% of patients. Planned admission before CT was 36 patients; after CT, it was 28 patients. Planned surgery before CT was 13 patients, and after CT, it was 10 patients. Thus, the net effect of abdominal CT scanning was to avert 8 (22.2%) of 36 possible hospital admissions, and 3 (23%) of 13 possible surgeries.
CONCLUSION
Abdominal CT performed in the emergency department significantly alters decision making when treating elderly patients with acute nontraumatic abdominal pain.

Keyword

Abdominal pain; Aged; Tomography; x-ray computed

MeSH Terms

Abdominal Pain*
Aged*
Data Collection
Decision Making
Diagnosis
Emergencies
Emergency Service, Hospital
Humans
Prospective Studies
Tomography, X-Ray Computed*