Longitudinal Trends in the Treatment of Abdominal Pain in an Academic Emergency Department
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 eval...
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| Veröffentlicht in: | The Journal of emergency medicine 2013-09, Vol.45 (3), p.324-331 |
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| container_title | The Journal of emergency medicine |
| container_volume | 45 |
| creator | Cinar, Orhan, MD Jay, Loni, MD Fosnocht, David, MD Carey, Jessica, BS Rogers, LeGrand, MD Carey, Adrienne, MD Horne, Benjamin, PhD Madsen, Troy, MD |
| description | 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 |
| doi_str_mv | 10.1016/j.jemermed.2013.01.020 |
| format | Article |
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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.</description><identifier>ISSN: 0736-4679</identifier><identifier>EISSN: 2352-5029</identifier><identifier>DOI: 10.1016/j.jemermed.2013.01.020</identifier><identifier>PMID: 23602146</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>abdominal pain ; Abdominal Pain - drug therapy ; Academic Medical Centers ; Adult ; analgesia ; Analgesics, Opioid - therapeutic use ; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use ; Emergency ; Emergency Department ; Emergency Service, Hospital - trends ; Female ; Humans ; Male ; Middle Aged ; Pain Management - trends ; Pain Measurement ; Patient Satisfaction - statistics & numerical data ; Prospective Studies ; Severity of Illness Index ; Time Factors ; Time-to-Treatment - trends ; Urban Health Services</subject><ispartof>The Journal of emergency medicine, 2013-09, Vol.45 (3), p.324-331</ispartof><rights>Elsevier Inc.</rights><rights>2013 Elsevier Inc.</rights><rights>Copyright © 2013 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c423t-71678eab7ab3acee92e572ccbe7cfbdcabaae1a1eefc9535c317eb902054eb593</citedby><cites>FETCH-LOGICAL-c423t-71678eab7ab3acee92e572ccbe7cfbdcabaae1a1eefc9535c317eb902054eb593</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jemermed.2013.01.020$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23602146$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cinar, Orhan, MD</creatorcontrib><creatorcontrib>Jay, Loni, MD</creatorcontrib><creatorcontrib>Fosnocht, David, MD</creatorcontrib><creatorcontrib>Carey, Jessica, BS</creatorcontrib><creatorcontrib>Rogers, LeGrand, MD</creatorcontrib><creatorcontrib>Carey, Adrienne, MD</creatorcontrib><creatorcontrib>Horne, Benjamin, PhD</creatorcontrib><creatorcontrib>Madsen, Troy, MD</creatorcontrib><title>Longitudinal Trends in the Treatment of Abdominal Pain in an Academic Emergency Department</title><title>The Journal of emergency medicine</title><addtitle>J Emerg Med</addtitle><description>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.</description><subject>abdominal pain</subject><subject>Abdominal Pain - drug therapy</subject><subject>Academic Medical Centers</subject><subject>Adult</subject><subject>analgesia</subject><subject>Analgesics, Opioid - therapeutic use</subject><subject>Anti-Inflammatory Agents, Non-Steroidal - therapeutic use</subject><subject>Emergency</subject><subject>Emergency Department</subject><subject>Emergency Service, Hospital - trends</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pain Management - trends</subject><subject>Pain Measurement</subject><subject>Patient Satisfaction - statistics & numerical data</subject><subject>Prospective Studies</subject><subject>Severity of Illness Index</subject><subject>Time Factors</subject><subject>Time-to-Treatment - trends</subject><subject>Urban Health Services</subject><issn>0736-4679</issn><issn>2352-5029</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU1v1DAQhi0EokvhL1Q5cknwRxI3F8SqlA9ppSK1vXCxxpNJcUicxU6Q9t_X6XYvXJAsWda874zneRm7ELwQXNQf-qKnkcJIbSG5UAUXBZf8BdtIVcm84rJ5yTZcqzova92csTcx9pwLzS_Fa3YmVc2lKOsN-7mb_IObl9Z5GLK7QL6NmfPZ_IvWF8wj-Tmbumxr22l8Ev2AVE8HfLZFaGl0mF2nvzyQx0P2mfYQnlxv2asOhkjvnu9zdv_l-u7qW767-fr9arvLsZRqzrWo9SWB1WAVIFEjqdIS0ZLGzrYIFoAECKIOm0pVqIQm26Rtq5Js1ahz9v7Ydx-mPwvF2YwuIg0DeJqWaEQpm7qsZKmStD5KMUwxBurMPrgRwsEIblaupjcnrmblargwaVIyXjzPWOxaO9lOIJPg01FAadO_joKJ6BIQal0gnE07uf_P-PhPCxycdwjDbzpQ7KclJPxpHxOl4eZ2TXcNV6gULE8sHwG1sqLZ</recordid><startdate>20130901</startdate><enddate>20130901</enddate><creator>Cinar, Orhan, MD</creator><creator>Jay, Loni, MD</creator><creator>Fosnocht, David, MD</creator><creator>Carey, Jessica, BS</creator><creator>Rogers, LeGrand, MD</creator><creator>Carey, Adrienne, MD</creator><creator>Horne, Benjamin, PhD</creator><creator>Madsen, Troy, MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130901</creationdate><title>Longitudinal Trends in the Treatment of Abdominal Pain in an Academic Emergency Department</title><author>Cinar, Orhan, MD ; Jay, Loni, MD ; Fosnocht, David, MD ; Carey, Jessica, BS ; Rogers, LeGrand, MD ; Carey, Adrienne, MD ; Horne, Benjamin, PhD ; Madsen, Troy, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c423t-71678eab7ab3acee92e572ccbe7cfbdcabaae1a1eefc9535c317eb902054eb593</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>abdominal pain</topic><topic>Abdominal Pain - drug therapy</topic><topic>Academic Medical Centers</topic><topic>Adult</topic><topic>analgesia</topic><topic>Analgesics, Opioid - therapeutic use</topic><topic>Anti-Inflammatory Agents, Non-Steroidal - therapeutic use</topic><topic>Emergency</topic><topic>Emergency Department</topic><topic>Emergency Service, Hospital - trends</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pain Management - trends</topic><topic>Pain Measurement</topic><topic>Patient Satisfaction - statistics & numerical data</topic><topic>Prospective Studies</topic><topic>Severity of Illness Index</topic><topic>Time Factors</topic><topic>Time-to-Treatment - trends</topic><topic>Urban Health Services</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cinar, Orhan, MD</creatorcontrib><creatorcontrib>Jay, Loni, MD</creatorcontrib><creatorcontrib>Fosnocht, David, MD</creatorcontrib><creatorcontrib>Carey, Jessica, BS</creatorcontrib><creatorcontrib>Rogers, LeGrand, MD</creatorcontrib><creatorcontrib>Carey, Adrienne, MD</creatorcontrib><creatorcontrib>Horne, Benjamin, PhD</creatorcontrib><creatorcontrib>Madsen, Troy, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cinar, Orhan, MD</au><au>Jay, Loni, MD</au><au>Fosnocht, David, MD</au><au>Carey, Jessica, BS</au><au>Rogers, LeGrand, MD</au><au>Carey, Adrienne, MD</au><au>Horne, Benjamin, PhD</au><au>Madsen, Troy, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Longitudinal Trends in the Treatment of Abdominal Pain in an Academic Emergency Department</atitle><jtitle>The Journal of emergency medicine</jtitle><addtitle>J Emerg Med</addtitle><date>2013-09-01</date><risdate>2013</risdate><volume>45</volume><issue>3</issue><spage>324</spage><epage>331</epage><pages>324-331</pages><issn>0736-4679</issn><eissn>2352-5029</eissn><abstract>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.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>23602146</pmid><doi>10.1016/j.jemermed.2013.01.020</doi><tpages>8</tpages></addata></record> |
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| subjects | abdominal pain Abdominal Pain - drug therapy Academic Medical Centers Adult analgesia Analgesics, Opioid - therapeutic use Anti-Inflammatory Agents, Non-Steroidal - therapeutic use Emergency Emergency Department Emergency Service, Hospital - trends Female Humans Male Middle Aged Pain Management - trends Pain Measurement Patient Satisfaction - statistics & numerical data Prospective Studies Severity of Illness Index Time Factors Time-to-Treatment - trends Urban Health Services |
| title | Longitudinal Trends in the Treatment of Abdominal Pain in an Academic Emergency Department |
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