title: Longitudinal trends in the treatment of abdominal pain in an academic emergency department.
abstract: BACKGROUND
  Abdominal pain is a top chief complaint of patients presenting to Emergency Departments (ED). Historically, uncertainty surrounded correct management. Evidence has shown adequate analgesia does not obscure the diagnosis, making it the standard of care.
  
  
  OBJECTIVE
  We sought to evaluate trends in treatment of abdominal pain in an academic ED during a 10-year period.
  
  
  METHODS
  We prospectively evaluated a convenience sample of patients in an urban academic tertiary care hospital ED from September 2000 through April 2010. Adult patients presenting with a chief complaint of abdominal pain were included in this study. Analgesic administration rates and times, pain scores, and patient satisfaction at discharge were analyzed to evaluate trends by year.
  
  
  RESULTS
  There were 2,646 patients presenting with abdominal pain who were enrolled during the study period. Rates of analgesic administration generally increased each year from 39.9% in 2000 to 65.5% in 2010 (p value for trend <0.001). Similarly, time to analgesic administration generally decreased by year, from 116 min in 2000 to 81 min in 2009 (p < 0.001). There was no improvement in mean pain scores at discharge by year (p = 0.27) and 48% of patients during the 10-year period still reported moderate to severe pain at discharge. Patient satisfaction with pain treatment increased from a score of 7.1 to 9.0 during the study period (p < 0.005), following the trend of increase in analgesic administration.
  
  
  CONCLUSIONS
  In patients presenting to the ED with abdominal pain, analgesia administration increased and time to medication decreased during the 10-year period. Despite overall improvements in satisfaction, significant numbers of patients presenting with abdominal pain still reported moderate to severe pain at discharge.
authors.affiliation: Division of Emergency Medicine, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Orhan
authors.initials: O
authors.lastname: Cinar
authors.forename: Loni
authors.initials: L
authors.lastname: Jay
authors.forename: David
authors.initials: D
authors.lastname: Fosnocht
authors.forename: Jessica
authors.initials: J
authors.lastname: Carey
authors.forename: LeGrand
authors.initials: L
authors.lastname: Rogers
authors.forename: Adrienne
authors.initials: A
authors.lastname: Carey
authors.forename: Benjamin
authors.initials: B
authors.lastname: Horne
authors.forename: Troy
authors.initials: T
authors.lastname: Madsen
mesh_terms: D015746:Abdominal Pain / Q000188:drug therapy*; D000046:Academic Medical Centers; D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D004636:Emergency Service, Hospital / Q000639:trends*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000639:trends*; D010147:Pain Measurement; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011446:Prospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D061665:Time-to-Treatment / Q000639:trends; D019037:Urban Health Services
chemical_list: D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: Emergency Department; abdominal pain; analgesia