Emergency department diagnosis of abdominal disorders in the elderly

Kenneth W Kizer, Mary J. Vassar

Research output: Contribution to journalArticle

37 Scopus citations

Abstract

To assess the accuracy of emergency department (ED) provisional diagnosis (ProDx) as compared with the hospital discharge diagnosis (HDDx) and the impact on hospital morbidity and mortality among nonelderly and elderly persons presenting with acute nontraumatic abdominal complaints, a retrospective review was conducted of 1,863 nonelderly (younger than 65 years) and 428 elderly (65 years or older) adults admitted to a university hospital from its ED. The sensitivity/specificity of the ProDx was 82%/86% for patients younger than 66 versus 68%/76% for those 65 or older. When the ProDx and HDDx did not agree, the overall disease-related morbidity was 16% for patients younger than 65 versus 45% for those 65 or older (P < .02). There were no differences in mortality based on agreement of the ProDx and HDDx. Prospective studies to determine the factors that are most useful in the ED diagnosis of acute nontraumatic abdominal disorders in the elderly are needed to improve the accuracy of diagnosis and reduce the incidence of morbidity in this high-risk group.

Original languageEnglish (US)
Pages (from-to)357-362
Number of pages6
JournalAmerican Journal of Emergency Medicine
Volume16
Issue number4
DOIs
StatePublished - 1998

Keywords

  • Abdominal disease
  • Aged
  • Differential diagnosis

ASJC Scopus subject areas

  • Emergency Medicine

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