The rate of short-term revisits after diagnosis of non-specific abdominal pain is similar for surgeons and emergency physicians - results from a single tertiary hospital emergency department

• Published in: Scandinavian journal of trauma, resuscitation and emergency medicine Vol. 28; no. 1; p. 63
• Main Authors: Saaristo, Leena, Ukkonen, Mika T, Laukkarinen, Johanna M, Pauniaho, Satu-Liisa K
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 01-07-2020; Springer Nature B.V; BioMed Central; BMC
• Subjects: Abdomen; Abdominal Pain - diagnosis; Adolescent; Adult; Age; Aged; Aged, 80 and over; Appendicitis; Child; Child, Preschool; Collaboration; Emergency medical care; Emergency Service, Hospital - statistics & numerical data; Family physicians; Female; Gallbladder diseases; Gynecology; Health aspects; Hospital emergency services; Hospitals; Hospitals, University - statistics & numerical data; Humans; Infant; Infant, Newborn; Laboratories; Male; Medical diagnosis; Medical imaging; Medical records; Medical referrals; Middle Aged; Mortality; Organizational change; Original Research; Pain; Pain management; Pancreatitis; Patient Discharge - trends; Patient Readmission - trends; Patients; Physicians; Retrospective Studies; Statistical analysis; Surgeons - standards; Surgery; Tertiary Care Centers - statistics & numerical data; Ultrasonic imaging; Young Adult
• ISSN: 1757-7241; 1757-7241
• DOI: 10.1186/s13049-020-00751-8

Acute abdominal pain can be a diagnostic challenge even for experienced surgeons. Delayed diagnosis can lead to higher morbidity, mortality and increased costs. While readmission rate has been used to evaluate quality of surgical care, studies addressing the issue in emergency departments (ED) are rare. The role of emergency physicians in the care of patients with abdominal pain is increasing in many European countries, including Finland. It is not known whether this has an effect on the number of readmissions. Here we evaluate whether the increasing role of emergency physicians in examining patients presenting with abdominal pain has affected the rate of short-term revisits among patients with non-specific abdominal pain (NSAP).
We identified consecutive ED patients receiving a diagnosis of NSAP 1.1. 2015-31.12.2016 in the ED of Tampere University Hospital. Those revisiting the ED within 48 h were selected for further analysis. Data were obtained from electronic medical records. We compared the outcomes of those initially examined by surgeons and by emergency physicians.
During the study period, 173,630 patients visited our ED, of whom 6.1% (n = 10,609) were discharged with a diagnosis of NSAP. Only 3.0% of patients revisited the ED, 0.7% required hospitalization and 0.06% immediate surgery. The short-term revisit rates among those originally examined by surgeons and by emergency physicians were similar, 2.8 and 3.2% respectively (p = 0.193).
The rate of short-term revisits in patients with NSAP was altogether low. The increasing role of emergency physicians in the care of acute abdominal patients did not affect the revisit rate.