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.
Keywords
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Article info
Publication history
Published online: April 22, 2013
Accepted:
January 18,
2013
Received in revised form:
October 3,
2012
Received:
March 21,
2012
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
