Effects of point-of-care ultrasonography on the diagnostic process of patients admitted to the emergency department with abdominal pain

Introduction-Aim: Abdominal pain is one of the most common reasons for admission to the emergency department. The aim of this study is to investigate how the bedside focused ultrasonography, which will be performed in the initial evaluation phase of patients presenting to the emergency department with abdominal pain, will affect the diagnostic processes, duration of stay in the emergency room, hospitalization and costs. Materials and Methods: As a prospective, parallel group study, on patients who are older than 18 years of age in the Emergency Service of Sakarya Training and Research Hospital, who do not have a history of abdominal trauma, pregnancy, morbid obesity and permanent mental disorder in the last 24 hours and who describe abdominal pain, it was performed by dividing the patients into groups in which the standard diagnosis strategy was applied with 1: 1 randomization (control group, n = 104) and emergency bedside ultrasonography (POCUS) (n = 103) in addition to the standard diagnosis strategy. The effect of Emergency POCUS on diagnostic process, duration of emergency service stay and average costs was analyzed with IBM SPSS 21 software. Results: The average age of 207 patients participating in the study was 50.6 (min: 18-maks: 89) and 53.6 % of them were women. The most common accompanying disease was hypertension (13%) and the symptom was nausea (46.9%). It was determined that the most common pathology detected during emergency POCUS application was stones or mud in the gallbladder (22.3%), the pre-diagnoses were significantly changed in the direction of a decrease, and the pre-diagnosis that underwent the most changes was acute appendicitis. The most common accompanying disease were hypertension (13 %), history of intra-abdominal operation (9,7 %) and diabetes mellitus (7,2 %), and the most common accompanying symptom was nausea (46.9%). It was found that the duration of emergency service was significantly reduced in patients diagnosed with acute appendicitis, patients with colic or persistent abdominal pain, patients used with plain radiography, both acute and chronic pain duration, and outcome in patients who were discharged and hospitalized (p<0,01). It was found that emergency YBUSG application reduced costs in patients with both acute and chronic pain and increased hospitalization rates. Conclusion: Emergency POCUS is a useful examination in terms of guiding the physician about pre-diagnoses in the emergency department, shortening the length of stay and increasing the hospitalization rates. However, additional studies including larger series to support this data are needed. Keywords: Abdominal pain, cost, emergency room, length of stay, ultrasonography