Aetiologies and outcomes of patients with abdominal pain presenting to an emergency department of a tertiary hospital in Tanzania: a prospective cohort study
Abstract Background Abdominal pain in adults represents a wide range of illnesses, often warranting immediate intervention. This study is to fill the gap in the knowledge about incidence, presentation, causes and mortality from abdominal pain in an established emergency department of a tertiary hosp...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-06-01
|
| Series: | BMC Gastroenterology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12876-020-01313-z |
| _version_ | 1818873096679981056 |
|---|---|
| author | Kilalo M. Mjema Hendry R. Sawe Irene Kulola Amour S. Mohamed Erasto Sylvanus Juma A. Mfinanga Ellen J. Weber |
| author_facet | Kilalo M. Mjema Hendry R. Sawe Irene Kulola Amour S. Mohamed Erasto Sylvanus Juma A. Mfinanga Ellen J. Weber |
| author_sort | Kilalo M. Mjema |
| collection | DOAJ |
| description | Abstract Background Abdominal pain in adults represents a wide range of illnesses, often warranting immediate intervention. This study is to fill the gap in the knowledge about incidence, presentation, causes and mortality from abdominal pain in an established emergency department of a tertiary hospital in Tanzania. Methods This was a prospective cohort study of adult (age ≥ 18 years) patients presenting to the Emergency Medicine Department of Muhimbili National Hospital (EMD-MNH) in Dar Es Salaam, Tanzania with non-traumatic abdominal pain from September 2017 to October 2017. A case report form was used to record data on demographics, clinical presentation, management, diagnosis, outcomes and patient follow-up. The primary outcome of mortality was summarized using descriptive statistics; secondary outcome was, risks for mortality. Results Among 3381 adult patients present during the study period, 288 (8.5%) presented with abdominal pain, and of these 199 (69%) patients were enrolled in our study. Median age was 47 years (IQR 35–60 years), 126 (63%) were female, and 118 (59%) were referred from another hospital. Most common final diagnoses were malignancies 71 (36%), intestinal obstruction 11 (6%) and peptic ulcer disease 9 (5%). Most common EMD interventions given were intravenous fluids 57 (21%), analgesia 49 (25%) and antibiotics 40 (20%). 160 (80%) were admitted of which 15 (8%) underwent surgery directly from EMD. 24-h and 7-day mortality were 4 (2%) and 7 (4%) respectively, while overall in hospital-mortality was 16 (8%). Among the risk factors for mortality were male sex Relative Risk (RR) 2.88 (p = 0.03), hypoglycemia (RR) 5.7 (p = 0.004), ICU admission (RR) 14 (p < 0.0001), receipt of IV fluids (RR) 3.2 (p = 0.0151) and need for surgery (RR) 6.6 (p = 0.0001). Conclusion Abdominal pain was associated with significant morbidity and mortality as evidenced by a very high admission rate, need for surgical intervention and a high in-hospital mortality rate. Future studies and quality improvement efforts should focus on identifying why such differences exist and how to reduce the mortality. |
| first_indexed | 2024-12-19T12:49:17Z |
| format | Article |
| id | doaj.art-ab28a8b0a20d497f8babeca98ac84eb2 |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-12-19T12:49:17Z |
| publishDate | 2020-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-ab28a8b0a20d497f8babeca98ac84eb22022-12-21T20:20:38ZengBMCBMC Gastroenterology1471-230X2020-06-012011610.1186/s12876-020-01313-zAetiologies and outcomes of patients with abdominal pain presenting to an emergency department of a tertiary hospital in Tanzania: a prospective cohort studyKilalo M. Mjema0Hendry R. Sawe1Irene Kulola2Amour S. Mohamed3Erasto Sylvanus4Juma A. Mfinanga5Ellen J. Weber6Emergency Medicine Department, Muhimbili University of Health and Allied ScienceEmergency Medicine Department, Muhimbili University of Health and Allied ScienceEmergency Medicine Department, Muhimbili University of Health and Allied ScienceEmergency Medicine Department, Muhimbili University of Health and Allied ScienceEmergency Medicine Department, Muhimbili University of Health and Allied ScienceEmergency Medicine Department, Muhimbili University of Health and Allied ScienceEmergency Medicine Department, Muhimbili National HospitalAbstract Background Abdominal pain in adults represents a wide range of illnesses, often warranting immediate intervention. This study is to fill the gap in the knowledge about incidence, presentation, causes and mortality from abdominal pain in an established emergency department of a tertiary hospital in Tanzania. Methods This was a prospective cohort study of adult (age ≥ 18 years) patients presenting to the Emergency Medicine Department of Muhimbili National Hospital (EMD-MNH) in Dar Es Salaam, Tanzania with non-traumatic abdominal pain from September 2017 to October 2017. A case report form was used to record data on demographics, clinical presentation, management, diagnosis, outcomes and patient follow-up. The primary outcome of mortality was summarized using descriptive statistics; secondary outcome was, risks for mortality. Results Among 3381 adult patients present during the study period, 288 (8.5%) presented with abdominal pain, and of these 199 (69%) patients were enrolled in our study. Median age was 47 years (IQR 35–60 years), 126 (63%) were female, and 118 (59%) were referred from another hospital. Most common final diagnoses were malignancies 71 (36%), intestinal obstruction 11 (6%) and peptic ulcer disease 9 (5%). Most common EMD interventions given were intravenous fluids 57 (21%), analgesia 49 (25%) and antibiotics 40 (20%). 160 (80%) were admitted of which 15 (8%) underwent surgery directly from EMD. 24-h and 7-day mortality were 4 (2%) and 7 (4%) respectively, while overall in hospital-mortality was 16 (8%). Among the risk factors for mortality were male sex Relative Risk (RR) 2.88 (p = 0.03), hypoglycemia (RR) 5.7 (p = 0.004), ICU admission (RR) 14 (p < 0.0001), receipt of IV fluids (RR) 3.2 (p = 0.0151) and need for surgery (RR) 6.6 (p = 0.0001). Conclusion Abdominal pain was associated with significant morbidity and mortality as evidenced by a very high admission rate, need for surgical intervention and a high in-hospital mortality rate. Future studies and quality improvement efforts should focus on identifying why such differences exist and how to reduce the mortality.http://link.springer.com/article/10.1186/s12876-020-01313-zAbdominal painNon-traumatic patientsEmergency departmentTanzaniaSub Saharan Africa |
| spellingShingle | Kilalo M. Mjema Hendry R. Sawe Irene Kulola Amour S. Mohamed Erasto Sylvanus Juma A. Mfinanga Ellen J. Weber Aetiologies and outcomes of patients with abdominal pain presenting to an emergency department of a tertiary hospital in Tanzania: a prospective cohort study BMC Gastroenterology Abdominal pain Non-traumatic patients Emergency department Tanzania Sub Saharan Africa |
| title | Aetiologies and outcomes of patients with abdominal pain presenting to an emergency department of a tertiary hospital in Tanzania: a prospective cohort study |
| title_full | Aetiologies and outcomes of patients with abdominal pain presenting to an emergency department of a tertiary hospital in Tanzania: a prospective cohort study |
| title_fullStr | Aetiologies and outcomes of patients with abdominal pain presenting to an emergency department of a tertiary hospital in Tanzania: a prospective cohort study |
| title_full_unstemmed | Aetiologies and outcomes of patients with abdominal pain presenting to an emergency department of a tertiary hospital in Tanzania: a prospective cohort study |
| title_short | Aetiologies and outcomes of patients with abdominal pain presenting to an emergency department of a tertiary hospital in Tanzania: a prospective cohort study |
| title_sort | aetiologies and outcomes of patients with abdominal pain presenting to an emergency department of a tertiary hospital in tanzania a prospective cohort study |
| topic | Abdominal pain Non-traumatic patients Emergency department Tanzania Sub Saharan Africa |
| url | http://link.springer.com/article/10.1186/s12876-020-01313-z |
| work_keys_str_mv | AT kilalommjema aetiologiesandoutcomesofpatientswithabdominalpainpresentingtoanemergencydepartmentofatertiaryhospitalintanzaniaaprospectivecohortstudy AT hendryrsawe aetiologiesandoutcomesofpatientswithabdominalpainpresentingtoanemergencydepartmentofatertiaryhospitalintanzaniaaprospectivecohortstudy AT irenekulola aetiologiesandoutcomesofpatientswithabdominalpainpresentingtoanemergencydepartmentofatertiaryhospitalintanzaniaaprospectivecohortstudy AT amoursmohamed aetiologiesandoutcomesofpatientswithabdominalpainpresentingtoanemergencydepartmentofatertiaryhospitalintanzaniaaprospectivecohortstudy AT erastosylvanus aetiologiesandoutcomesofpatientswithabdominalpainpresentingtoanemergencydepartmentofatertiaryhospitalintanzaniaaprospectivecohortstudy AT jumaamfinanga aetiologiesandoutcomesofpatientswithabdominalpainpresentingtoanemergencydepartmentofatertiaryhospitalintanzaniaaprospectivecohortstudy AT ellenjweber aetiologiesandoutcomesofpatientswithabdominalpainpresentingtoanemergencydepartmentofatertiaryhospitalintanzaniaaprospectivecohortstudy |