A 5-year follow up of patients discharged with non-specific abdominal pain: out of sight, out of mind?
OBJECTIVE
Acute non-specific abdominal pain (NSAP) is prevalent in 6-25% of the general population and is a common cause of admission to the emergency department (ED). Despite involvement of substantial financial and human resources, there are few data on long-term outcome after initial diagnosis. The aim of this study was to evaluate long-term outcome of patients initially admitted with NSAP to an ED.


METHODS
The study involves a 5-year follow-up analysis of prospectively collected data on 104 patients admitted to our ED in 2003 with NSAP. Primary end-point was clinical outcome 5 years after initial ED admission. Predictive risk factors were assessed using a multivariate regression model.


RESULTS
29 patients (28%) had recurring NSAP 5 years after initial ED admission, 76% of these patients received (multiple) diagnostic examinations and 13% eventually required diagnostic (or therapeutic) surgery. Although approximately half of patients with recurring NSAP eventually received a definite diagnosis, 30% still suffered from recurrent abdominal pain. Using regression analysis, no single factor in our dataset could be identified as a predictor for NSAP persistence.


CONCLUSIONS
The long-term impact for patients initially admitted to our ED with acute NSAP is significant--28% of patients continue to suffer from recurring NSAP after 5 years. NSAP therefore remains, despite more advanced diagnostic tools, a true and, as yet, unsolved problem.
Banz
V M
VM
Department of Visceral Surgery, Inselspital, Berne University Hospital and University of Berne, Berne, Switzerland. vanessa.banz@gmx.ch
Sperisen
O
O
de Moya
M
M
Zimmermann
H
H
Candinas
D
D
Mougiakakou
S G
SG
Exadaktylos
A K
AK
D015746:Abdominal Pain / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data*; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D016896:Treatment Outcome; D055815:Young Adult