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The role of plain radiographs in patients with acute abdominal pain at the ED
- Source :
- American Journal of Emergency Medicine, 29, 6, pp. 582-589 e2, American Journal of Emergency Medicine, 29, 582-589 e2, American journal of emergency medicine, 29(6), 582-589.e2. W.B. Saunders Ltd, American journal of emergency medicine, 29(6), 582-U22. ELSEVIER SCIENCE INC
- Publication Year :
- 2011
-
Abstract
- Objective: The purpose of this study was to evaluate the added value of plain radiographs on top of clinical assessment in unselected patients presenting with acute abdominal pain at the emergency department (ED). Methods: In a multicenter prospective trial, patients with abdominal pain more than 2 hours and less than 5 days presented at the ED were evaluated clinically, and a diagnosis was made by the treating physician. Subsequently, all patients underwent supine abdominal and upright chest radiographs, after which the diagnosis was reassessed by the treating physician. A final (reference) diagnosis was assigned by an expert panel. The number of changes in the primary diagnosis, as well as the accuracy of these changes, was calculated. Changes in the level of confidence were evaluated for unchanged diagnoses. Results: Between March 2005 and November 2006, 1021 patients, 55% female, mean age 47 years (range, 19-94 years), were included. In 117 of 1021 patients, the diagnosis changed after plain radiographs, and this change was correct in 39 patients (22% of changed diagnoses and 4% of total study population). Overall, the clinical diagnosis was correct in 502 (49%) patients. The diagnosis after evaluation of the radiographs was correct in 514 (50%) patients, a nonsignificant difference (P = .14). In 65% of patients with unchanged diagnosis before and after plain radiography, the level of confidence of that diagnosis did not change either. Conclusion: The added value of plain radiographs is too limited to advocate their routine use in the diagnostic workup of patients with acute abdominal pain, because few diagnoses change and the level of confidence were mostly not affected. (C) 2011 Elsevier Inc. All rights reserved.
- Subjects :
- Male
Abdominal pain
Time Factors
ACCURACY
HELICAL-CT
Pneumoperitoneum
Prospective Studies
Medical diagnosis
skin and connective tissue diseases
Aged, 80 and over
General Medicine
SMALL-BOWEL OBSTRUCTION
Middle Aged
EMERGENCY
Bowel obstruction
Acute abdomen
Predictive value of tests
Emergency Medicine
Female
Radiology
medicine.symptom
SENSITIVITY
Emergency Service, Hospital
Adult
medicine.medical_specialty
Adolescent
DIAGNOSIS
Sensitivity and Specificity
Diagnosis, Differential
Predictive Value of Tests
Intensive care
TOMOGRAPHY
medicine
Humans
PNEUMOPERITONEUM
Aged
Chi-Square Distribution
business.industry
Emergency department
medicine.disease
Surgery
Abdominal Pain
Radiography
Evaluation of complex medical interventions [NCEBP 2]
X-RAY
sense organs
business
Plain radiography
Subjects
Details
- ISSN :
- 07356757
- Database :
- OpenAIRE
- Journal :
- American Journal of Emergency Medicine, 29, 6, pp. 582-589 e2, American Journal of Emergency Medicine, 29, 582-589 e2, American journal of emergency medicine, 29(6), 582-589.e2. W.B. Saunders Ltd, American journal of emergency medicine, 29(6), 582-U22. ELSEVIER SCIENCE INC
- Accession number :
- edsair.doi.dedup.....0ccd0f93fbab8f19e1ae8909f9d97eb9
- Full Text :
- https://doi.org/10.1016/j.ajem.2009.12.020