Prospective evaluation of the patients aged 65 and older WHO consulted to the emergency service with the complaint of abdominal pain

Prospective Evaluation of the Patients Aged 65 and Older Who Consulted to the Emergency Service with the Complaint of Abdominal Pain Purpose: Our study was conducted to compare the pain-causing diagnoses of patients aged 65 or over who consulted to the emergency service (ES) with the complaint of non-traumatic abdominal pain and the diagnosis differences; the rate of hospitalization, the effect of adverse symptoms which were seen during the admission to the hospital, the frequency of surgical diagnosis, the rate of consultation demand, the frequency of vital sign abnormalities, the effect of additional diseases on the diagnoses of geriatric (65-74 years) and high geriatric (75 years and older) patients, male and female patients, the patients with surgical and internal disease diagnosis. Material and method: 150 patients who consulted to our emergency service with the complaint of non-traumatic abdominal pain were taken in the study. The age groups, gender and internal or surgical pre-diagnoses of the patients and complaints which accompany the abdominal pain, vital signs, examination findings, concomitant diseases, consultations which were demanded, diagnoses, results and the units where the patients were hospitalized were compared and it was checked if there was a correlation between them. Findings:50.7% of the patients included in the study were female and 49.3% were male while 45.3% of them were between 65-74 years old and 54.7% of them were 75 years old or over. The mean age of the patients was 77.21 (65-98) years. An internal disease was diagnosed as the cause of the abdominal pain in 78.6% of the patients. The most common pre-diagnoses were gall bladder and tract diseases, nonspecific abdominal pain, urinary tract infection (UTI), ileus, acute gastroenteritis (AGE) and pancreatitis, respectively, in terms of frequency order. The most common symptom that accompanied abdominal pain was nausea and vomiting and inaccitence, flatulation and defecation failure were observed more in patients with abdominal pain causing from surgical reasons (p<0.05). The rates of nausea, vomiting, diarrhoea, dysuria and constipation findings of the patients who were diagnosed with internal diseases were higher than those of the patients who were diagnosed with surgical diseases (p<0.05). The findings about fever of the 65-74 age group were higher than the findings of the 75 years old or over (p<0.05). The most common chronic disease that accompanied abdominal pain in both age groups was hypertension (HT) and HT was more common in women than men (p<0.05). The rate of asthma-chronic obstructive pulmonary disease (COPD) and malignancy comorbidity in male patients was higher than the rate of female patients (p<0.05). While consultations for 50% of the patients who were included in our study were demanded from the related services, the general surgery and internal diseases departments were the services from which consultations were demanded the most. The rate of consultation demand was higher in patients with surgical diagnosis (p<0.05). While 36% of the patients were hospitalized, general surgery intensive care unit was the unit where the patients were hospitalized the most (18%). In terms of hospitalization, the hospitalization rate of the patients with surgical diagnosis in the intensive care unit was higher than the hospitalization rate of the patients with internal diseases diagnosis in the intensive care unit (p<0.05). Conclusion: As clinical symptoms are subtle and atypical presentations are common in elderly patients, we believe that doctors should know physiological changes depending on the age and evaluate elderly patients more carefully so as to distinguish the patients who consulted to the emergency service with abdominal pain from emergency pathological cases. Keywords: Emergency service, Geriatric patient, Abdominal pain