title: Vomiting and Hyponatremia Are Risk Factors for Worse Clinical Outcomes Among Patients Hospitalized Due to Nonsurgical Abdominal Pain: A Retrospective Cohort Study.
abstract: After initial evaluation in the Emergency Department (ED), many patients complaining of abdominal pain are classified as suffering from nonsurgical abdominal pain (NSAP). Clinical characteristics and risk factors for worse prognosis were not published elsewhere.Characterizing the clinical profile of patients hospitalized due to NSAP and identifying predictor variables for worse clinical outcomes.We made a retrospective cohort analysis of patients hospitalized due to NSAP compared to matched control patients (for age, gender, and Charlson comorbidity index) hospitalized due to other, nonsurgical reasons in a ratio of 1 to 10. We further performed in-group analysis of patients admitted due to NSAP in order to appreciate variables (clinical and laboratory parameters) potentially associated with worse clinical outcomes.Overall 23,584 patients were included, of which 2144 were admitted due to NSAP and 21,440 were matched controls. Patients admitted due to NSAP had overall better clinical outcomes: they had lower rates of in-hospital and 30-days mortality (2.8% vs 5.5% and 7.9% vs 10.4% respectively, P < 0.001 for both comparisons). They also had a significantly shorter length of hospital stay (3.9 vs 6.2 days, P < 0.001). Rates of re-hospitalization within 30-days were not significantly different between study groups. Among patients hospitalized due to NSAP, we found that vomiting or hyponatremia at presentation or during hospital stay were associated with worse clinical outcomes.Compared to patients hospitalized due to other, nonsurgical reasons, the overall prognosis of patients admitted due to NSAP is favorable. The combination of NSAP with vomiting and hyponatremia is associated with worse clinical outcomes.
authors.affiliation: From the Internal Medicine "T," Chaim Sheba Medical Center (IG, IK, IG, AD, GS), Tel Hashomer, Ramat Gan*; Clalit Health Services (AI), Jerusalem; Sackler Faculty of Medicine (NC, OS), Tel-Aviv University, Tel Aviv; Technologies Management (BL), Chaim Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Idan
authors.initials: I
authors.lastname: Goren
authors.forename: Ariel
authors.initials: A
authors.lastname: Israel
authors.forename: Narin N
authors.initials: NN
authors.lastname: Carmel-Neiderman
authors.forename: Iris
authors.initials: I
authors.lastname: Kliers
authors.forename: Irina
authors.initials: I
authors.lastname: Gringauz
authors.forename: Amir
authors.initials: A
authors.lastname: Dagan
authors.forename: Bruno
authors.initials: B
authors.lastname: Lavi
authors.forename: Omer
authors.initials: O
authors.lastname: Segal
authors.forename: Gad
authors.initials: G
authors.lastname: Segal
mesh_terms: D015746:Abdominal Pain / Q000150:complications* / Q000401:mortality; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D007010:Hyponatremia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission; D012189:Retrospective Studies; D012307:Risk Factors; D014839:Vomiting / Q000150:complications*