Randomized clinical trial of bedside ultrasound among patients with abdominal pain in the emergency department: impact on patient satisfaction and health care consumption.
BACKGROUND
Previous research shows that surgeon-performed ultrasound for patients presenting with abdominal pain in the emergency department leads both to higher diagnostic accuracy and to other benefits. We have evaluated the level of patient satisfaction, health condition and further health care consumption after discharge from the emergency department.


METHODS
A total of 800 patients who attended the emergency department for abdominal pain were randomized to surgeon-performed ultrasound or not as a complement to standard examination. All patients were interviewed by telephone six weeks after the visit to the emergency department using a structured questionnaire including information about health condition, satisfaction and medical examinations. A regional health register was used to check health care consumption over two years and mortality was checked for in the personal data register.


RESULTS
We found a higher self-rated patient satisfaction in the ultrasound group when leaving the emergency department. After six weeks the figures were equal. There were fewer patients in the ultrasound group with completed or planned complementary examinations after six weeks (31.1%) compared with the control group (41.4%), p=0.004. There was no difference found in the two-year health care consumption or mortality between the groups.


CONCLUSIONS
For patients with acute abdominal pain, bedside ultrasound examination is related to higher satisfaction and decreased short-term health care consumption. No major effects were revealed when evaluating effects on a long-term basis, including mortality. The previously proven benefit together with the lack of adverse effects from the method makes ultrasound well worth considering for implementation in emergency departments.


BACKGROUND
The study has been registered in ClinicalTrials.gov ID NCT00550511.
Lindelius
Anna
A
Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden. anna.lindelius@sodersjukhuset.se
Törngren
Staffan
S
Nilsson
Laila
L
Pettersson
Hans
H
Adami
Johanna
J
D000005:Abdomen / Q000000981:diagnostic imaging*; D015746:Abdominal Pain / Q000209:etiology*; D000328:Adult; D000368:Aged; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D019095:Point-of-Care Systems; D013548:Sweden; D014463:Ultrasonography