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Nonspecific abdominal pain in the Emergency Department: malignancy incidence in a nationwide Swedish cohort study
Karolinska Institutet, Stockholm, Sweden.ORCID iD: 0000-0002-4062-4470
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2018 (English)In: European journal of emergency medicine, ISSN 0969-9546, E-ISSN 1473-5695, Vol. 25, no 2, p. 105-109Article in journal (Refereed) Published
Abstract [en]

INTRODUCTIONThe role of emergency physicians is to identify patients in need of immediate treatment, but also to identify symptoms indicative of serious, if not immediately life-threatening conditions. AIMTo assess whether symptoms described as nonspecific abdominal pain (NSAP) could be the first indication of an abdominal malignancy. MATERIALS AND METHODSThis was a nationwide registry-based cohort study of all patients discharged with NSAP from Swedish Emergency Departments (EDs) during the year 2011, based on Swedish patient registries of inpatient and outpatient care, and the cause of death registry, studying patients diagnosed with de novo cancer within a year after their NSAP discharge. RESULTSOf 24 801 patients discharged with NSAP in 2011, 2.2% were assigned a cancer diagnosis within 12 months. Almost 20% of patients diagnosed with a malignancy died within the year, and 16% of these deaths occurred within a month after the ED visit. The majority of patients with cancer were 60 years of age or older, and thus significantly older than the remaining NSAP patients. Patients with malignancies also had a greater number of comorbidities than the remaining NSAP patients (P<0.01). CONCLUSIONA small percentage of patients discharged with NSAP from Swedish EDs are diagnosed with a malignancy within a year. Patients aged 60 years or older and with comorbidities were over-represented in terms of developing malignancies after discharge. Emergency physicians should be aware of the fact that diffuse abdominal symptoms in elderly patients could be the first sign of an underlying malignancy and more liberally refer such patients for follow-up in primary care.

Place, publisher, year, edition, pages
Copyright Wolters Kluwer Health, Inc. All rights reserved , 2018. Vol. 25, no 2, p. 105-109
Keywords [en]
Care and treatment ; Emergency medicine ; Gastrointestinal diseases ; Abdominal pain ; Aged patients ; Diagnosis ; Identification and classification ; Methods ; Index Medicus ; Medicin och hälsovetenskap
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Cardiac and Cardiovascular Systems
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URN: urn:nbn:se:du-36993DOI: 10.1097/MEJ.0000000000000409OAI: oai:DiVA.org:du-36993DiVA, id: diva2:1556886
Available from: 2021-05-24 Created: 2021-05-24 Last updated: 2021-05-24Bibliographically approved

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Publisher's full texthttps://journals.lww.com/euro-emergencymed/Abstract/2018/04000/Nonspecific_abdominal_pain_in_the_Emergency.6.aspx

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Göransson, Katarina

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