Analysis of the relationship between individual pain scores and outcomes in elderly patients admitted to the emergency department with acute abdominal pain

SUMMARYAnalysis of the relationship between individual pain scores and outcomes inelderly patients admitted to the emergency department with acute abdominalpainDr. Yahya Kemal ÖZENBackground: The population becomes older every year, associated with anincrease in the numbers of elderly patients cared in the emergency department (ED).It is difficult to evaluate the elderly presented to the ED with acute abdominal pain(AAP) due to the physiologic and pathologic processes.Study objectives: To analyze pain scores reported by the geriatric patientadmitted to the ED with AAP and their relationship with short-term clinical outcomes.Method: All consecutive patients older than 65 admitted to the University-basedED with AAP in one year were enrolled in the study. They reported the severity of thepain individually using Verbal Analog Scale. Patients' demographics, healthinsurance, the characteristics, time course of, and the body area affected by pain,presumptive diagnoses, outcome in one month were recorded. The relationshipbetween pain scores and age, sex, environment, presence of diabetes, usinganalgesic drugs were evaluated. Analyses were performed in 95% confidenceinterval and p values below 0.05 was significant.Results: In the one-year study period (01.03.2005-28.02.2006), 8705 elderlypatients presented to the ED. Seventy-seven patients (45 women, 58.4%) with AAPwere recruited. All patients had health insurance. 67 (87%) were living with relatives.45 (58.4%) of patients presented within 24 hours and 70 (%90.4) of them hadongoing pain on admission. 37 (48.1%) of patients had diffuse abdominal pain. Nosignificant relationship were found between pain scores and hospitalization,operation and mortality in this sample of geriatric patients. (p>0.05)Conclusions: The pain description of the elderly patients admitted to the EDwith AAP failed to predict the outcome. The individual pain scores using VAS werenot found to be affected by demographics, analgesic use, and presence of DM.Key words: acute abdominal pain, outcome, visual analog scale, elderly,