J Korean Soc Emerg Med.  2007 Dec;18(6):563-569.

Clinical Utility of Abdominal MDCT in Elderly Patients with Non-traumatic Acute Abdominal Pain

• Jeon WY
• Jeong TO
• Jin YH
• Lee JB

Abstract

PURPOSE: The purposes of this study are to determine the degree of diagnostic consistency among the primary diagnosis in the emergency department (ED), abdominal multidetector computed tomography (MDCT) findings, and the final diagnosis at hospital discharge in elderly patients with non-traumatic acute abdominal pain; to describe common disease entities in these patients; and to determine the extent of agreement between management plans before and after abdominal MDCT.
METHODS
We undertook the retrospective review of the charts of 109 patients, 65 years or older with non-traumatic acute abdominal pain. The measure of agreement between diagnostic phases and between planned and actual management was evaluated by Cohen's kappa statistic.
RESULTS
Value of the kappa statistic for agreement between primary diagnosis in the ED and final diagnosis at hospital discharge and between MDCT findings and final diagnosis were 0.408 and 0.776, respectively. The most common MDCT findings were biliary disease (17.4%), ischemic bowel disease (16.5%) and malignancy (16.5%). At the time of final diagnosis at hospital discharge, the order of frequency was malignancy (16.5%), biliary disease (15.6%), and ischemic bowel disease (12.8%). The degree of agreement between before and after abdominal MDCT in management plans was 0.154.
CONCLUSION
Abdominal MDCT can skew diagnosis and management plans significantly in elderly patients with nontraumatic acute abdominal pain.

Keyword

Abdominal pain; Aged; Tomography; Computed

MeSH Terms

Abdominal Pain*
Aged*
Diagnosis
Emergency Service, Hospital
Humans
Multidetector Computed Tomography
Retrospective Studies