Title: Factors associated with unfavorable outcomes in acute abdominal pain<br/>
Author: Neeraja Murali<br/>
<a href='mailto:nmurali@som.umaryland.edu'>[Click to email author]</a><hr/>
Link: <a href='https://umem.org/educational_pearls/4404/'>https://umem.org/educational_pearls/4404/</a><hr/><p>This retrospective cohort study examined patients over a one year period to evaluate factors associated with unfavorable outcomes in acute abdominal pain. </p>
<p>Unfavorable outcomes were defined as any of the following: 1) shock requiring an invasive procedure such as central line insertion or mechanical ventilation 2) emergency surgery 3) post-operative complications OR 4) in-hospital cardiac arrest</p>
<p>951 patients were included in the study. </p>
<p>Physical exam and laboratory signs associated with the above unfavorable outcomes included:</p>
<p>-diastolic BP < 80 mmHG</p>
<p>-RR ? 24/min</p>
<p>-RLQ tenderness</p>
<p>-abd distension</p>
<p>-hypoactive bowel sounds</p>
<p>-presence of specific abdominal signs (ie Murphy's sign, psoas sign, etc).</p>
<p>-leukocytosis</p>
<p>-ANC >75%</p>
<p>Further, ED Length of Stay of > 4 hours was also associated with unfavorable outcomes.</p>
<p>Food for thought when considering serial abdominal exams when diagnosis is unclear…</p>
<fieldset><legend>References</legend><p>Dadeh AA. Factors associated with unfavorable outcomes in patients with acute abdominal pain visiting the emergency department. BMC Emerg Med. 2022 Dec 6;22(1):195. doi: 10.1186/s12873-022-00761-y. PMID: 36474160; PMCID: PMC9727909.</p>
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