title: [Patients with Acute, Non-Traumatic Abdominal Pain in German Emergency Departments: A Prospective Monocentric Observation Study].
abstract: Background:Up to 11 % of patients in an Emergency Department (ED) present with non-traumatic acute abdominal pain. Based on this presenting symptom, this study aimed to analyse how residents (surgery, internal medicine, anaesthesiology and other fields) working in an ED during their second and third year of education treat these patients.Material and Methods:We performed a prospective, monocentric observation study in an ED in accordance with the STROBE recommendations, following the recommendations from the Ethics Committee of the University of Ulm (application no. 335/12) and the Declaration of Helsinki. The hospital's data protection officer approved the study. During a 12-month period (Dec. 2012 to Dec. 2013), a random sample of patients with non-traumatic abdominal pain was obtained in the ED of a major German acute care hospital by an independent observer, who was not part of the ED team. In addition to demographic data, the study focused on analysing processes and patient care (including medical history taking and physical examinations). In addition, subgroups were defined (clinical background of the treating physician, severity pursuant to the Manchester Triage Score [MTS]).Results:143 patients met the inclusion criteria. The clinical background of the physician had no influence on the reviewed processes such as medical history taking, initial examinations, the request of consultative examinations or diagnostic procedures. Patients triaged as "urgent" were treated significantly earlier than patients triaged as "non-urgent" (time to first physician contact 26 ± 24 vs. 46 ± 34 min, p < 0.001). However, the overall time spent in the ED was equal (210 ± 79 vs. 220 ± 114 min, p = 0.555). Yet the initially estimated urgency was correlated with the need for hospitalisation (share: 57 %).Conclusion:The overall compliance with standards of care was high. The clinical background (surgery, internal medicine, anaesthesiology, other fields) of the physician in charge of initial treatment had no influence on the reviewed processes.
authors.affiliation: Klinik für Anästhesiologie und Intensivmedizin - Sektion Notfallmedizin, Bundeswehrkrankenhaus Ulm, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Kulla
authors.affiliation: Klinik für Anästhesiologie und Intensivmedizin, Bundeswehrkrankenhaus Ulm, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Kraus
authors.affiliation: Klinik für Unfallchirurgie, Universitätsklinikum Magdeburg, Deutschland.
authors.forename: F
authors.initials: F
authors.lastname: Walcher
authors.affiliation: Interdisziplinäre Rettungsstelle und Aufnahmestation, Charité - Universitätsmedizin Berlin - Campus Benjamin Franklin, Deutschland.
authors.forename: R
authors.initials: R
authors.lastname: Somasundaram
authors.affiliation: Interdisziplinäres Notfallzentrum mit Rettungsstelle, Helios Klinikum Berlin-Buch, Deutschland.
authors.forename: C E
authors.initials: CE
authors.lastname: Wrede
authors.affiliation: Klinik für Anästhesiologie und Intensivmedizin, Bundeswehrkrankenhaus Ulm, Deutschland.
authors.forename: L
authors.initials: L
authors.lastname: Lampl
authors.affiliation: Klinik für Anästhesiologie und Intensivmedizin - Sektion Notfallmedizin, Bundeswehrkrankenhaus Ulm, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Helm
mesh_terms: D000006:Abdomen, Acute / Q000209:etiology* / Q000628:therapy*; D000328:Adult; D000368:Aged; D003479:Curriculum; D004635:Emergency Medicine / Q000193:education*; D004636:Emergency Service, Hospital; D005260:Female; D013502:General Surgery / Q000193:education*; D005858:Germany; D006760:Hospitalization; D006785:Hospitals, University; D006801:Humans; D007396:Internship and Residency; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D012017:Referral and Consultation; D014218:Triage