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J Korean Soc Emerg Med > Volume 18(6); 2007 > Article
Journal of The Korean Society of Emergency Medicine 2007;18(6): 563-569.
Clinical Utility of Abdominal MDCT in Elderly Patients with Non-traumatic Acute Abdominal Pain
Woo Young Jeon, Tae O Jeong, Young Ho Jin, Jae Baek Lee
1Department of Emergency Medicine, Medical School, Chonbuk National University, Jeonju, Korea. emjin@chonbuk.ac.kr
2Institute for Medical Science, Medical School, Chonbuk National University, Jeonju, Korea.
The purposes of this study are to determine the degree of diagnostic consistency among the primary diagnosis in the emergency department (ED), abdominal multidetector computed tomography (MDCT) findings, and the final diagnosis at hospital discharge in elderly patients with non-traumatic acute abdominal pain; to describe common disease entities in these patients; and to determine the extent of agreement between management plans before and after abdominal MDCT.
We undertook the retrospective review of the charts of 109 patients, 65 years or older with non-traumatic acute abdominal pain. The measure of agreement between diagnostic phases and between planned and actual management was evaluated by Cohen's kappa statistic.
Value of the kappa statistic for agreement between primary diagnosis in the ED and final diagnosis at hospital discharge and between MDCT findings and final diagnosis were 0.408 and 0.776, respectively. The most common MDCT findings were biliary disease (17.4%), ischemic bowel disease (16.5%) and malignancy (16.5%). At the time of final diagnosis at hospital discharge, the order of frequency was malignancy (16.5%), biliary disease (15.6%), and ischemic bowel disease (12.8%). The degree of agreement between before and after abdominal MDCT in management plans was 0.154.
Abdominal MDCT can skew diagnosis and management plans significantly in elderly patients with nontraumatic acute abdominal pain.
Key words: Abdominal pain, Aged, Tomography, Computed
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