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Significance of Tomography and CRP in Abdominal Pain Management

Year 2015, Volume: 40 Issue: 4, 766 - 773, 02.10.2015
https://doi.org/10.17826/cutf.94425

Abstract

Purpose: We evaluated whether abdominal tomography is necessary for patients who have been admitted to the emergency service because of non traumatic abdominal pain and effect of C-Reactive Protein (CRP) and tomography to the patient management. Materials and Method: On retrospective study, we recorded demographic data, tomography diagnoses, CRP and leucocyte values operation and following decisions of 199 patient who were 18 years old and over and were admitted to emergency service because of abdominal pain and were scanned abdominal tomography. 104 patient were hospitalized and their CRP values, tomography diagnoses, end of operation diagnoses were recorded from patient files. The statistical analysis was performed using the Chi-square test and the diagnostic value was assessed through the logistic regression test. Results: A statistically significant relationship was observed between anormal tomography findings and high CRP and leukocyte values of the 199 patients included in the study. The tomography findings and CRP values were found to be efficient in discharge and hospitalization rates. When tomography finding and CRP value were combined, the operation decision was effected. Conclusion: Based on our study; in the event of abdominal pain, CRP can predict abnormal tomography finding and it is more valuable than leucocyte. When tomography was used with CRP, it affects the operation decision.

References

  • Strömberg C, Johansson G, Adolfsson A. Acute Abdominal Pain: Diagnostic Impact of Immediate CT Scanning. World J Surg. 2007;31:2347–54
  • Scheinfeld MH, Mahadevia S, Stein EG, Freeman K, Rozenblit AM. Can lab data be used to reduce abdominal computed tomography (CT) usage in young adults presenting to the emergency department with nontraumatic abdominal pain?. Emerg Radiol. 2010;17:353–60
  • Keijzers GB, Britton CJ. Doctors’ knowledge of patient radiation exposure from diagnostic imaging requested in the emergency department. Med J Aust. 2010;193:450–3.
  • Clyne B, Olshaker JS. The C-reactive protein. J Emerg Med. 1999;17:1019-25.
  • Tamanna MZ, Eram U, Al Harbi TM, Alrashdi SA, Khateeb SU, Aladhrai SA et al. Clinical value of leukocyte counts in evaluation of patients with suspected appendicitis in emergency department. Ulus Travma Acil Cerrahi Derg. 2012;18:474-8.
  • Gore RM, Miller FH, Pereles FS, Yaghmai V, Berlin JW. Helical CT in the evaluation of the acute abdomen. AJR Am J Roentgenol. 2000;174:901–13.
  • Rosen MP, Siewert B, Sands DZ, Bromberg R, Edlow J, Raptopoulos V. Value of abdominal CT in the emergency department for patients with abdominal pain. Eur Radiol. 2003;13:418–24.
  • Ng CS, Watson CJ, Palmer CR, See TC, Beharry NA, Housden BA et al. Evaluation of early abdominopelvic computed tomography in patients with acute abdominal pain of unknown cause: prospective randomized study. BMJ. 2002;325:1387– 95.
  • Lee J, Kirschner J, Pawa S, Wiener DE, Newman DH, Shah K. Computed Tomography Use in the Adult Emergency Department of an Academic Urban Hospital From 2001 to 2007. Ann Emerg Med. 2010;56:591-6.
  • Hastings RS, Powers RD. Abdominal pain in the ED: a 35 year retrospective. Am J Emerg Med. 2011;29:711–6.
  • Frei SP, Bond WF, Bazuro RK, Richardson DM, Sierzega GM, Reed JF. Appendicitis outcomes with increasing computed tomographic scanning. Am J Emerg Med. 2008;26:39-44.
  • Abujudeh HH, Kaewlai R, McMahon PM, Binder W, Novelline RA, Gazelle GS et al. Abdominopelvic CT Increases Diagnostic Certainty and Guides Management Decisions: A Prospective Investigation of 584 Patients in a Large Academic Medical Center. AJR Am J Roentgenol. 2011;196:238–43.
  • Rosen MP, Sands DZ, Longmaid HE 3re, Reynolds KF, Wagner M, Raptopoulos V. Impact ofabdominal CT on the management of patients presentingto the emergency department with acute abdominal pain. AJR Am J Roentgenol. 2000;174:1391–6.
  • Lewis LM, Klippel AP, Bavolek RA, Ross LM, Scherer TM, Banet GA. Quantifying the usefulness of CT in evaluating seniors with abdominal pain. Eur J Radiol. 2007;61:290–6.
  • Coyle JP, Brennan CR, Parfrey SF, O'Connor OJ, Mc Laughlin PD, Mc Williams SR et al. Is serum C- reactive protein a reliable predictor of abdomino- pelvic CT findings in the clinical setting of the non- traumatic acute abdomen?. Emerg Radiol. 2012;19:455-62.
  • Chi CH, Shiesh SC, Chen KW, Wu MH, Lin XZ. C- reactive protein for the evaluation of acute abdominal pain. Am J Emerg Med. 1996;14:254-6.

Karın Ağrısının Yönetiminde Tomografi ve CRP’nin Önemi

Year 2015, Volume: 40 Issue: 4, 766 - 773, 02.10.2015
https://doi.org/10.17826/cutf.94425

Abstract

Amaç: Çalışmamızda, acil servise travma dışı karın ağrısı başvurularında abdominal tomografinin gerekliliğini değerlendirdik. Bu sayede, C-Reaktif Protein (CRP) ve tomografi bulgularının hastanın yönetimine etkisini ölçmeyi amaçladık. Materyal ve Metod: Geriye dönük yapılan çalışmada acil servise karın ağrısı ile başvurup abdominal tomografi çekilen 18 yaş ve üzeri 199 hastanın demografik özellikleri, tomografi bulguları, CRP ve lökosit değerleri, yatış veya taburculuk kararları ile hastaneye yatışı yapılan 104 hastanın CRP değerleri, tomografi tanıları, operasyon sonu tanıları hasta dosyalarından kaydedildi. İstatistiksel analizde ki-kare, tanısal değerliliğin ölçülmesinde ise lojistik regresyon testi kullanıldı. Bulgular: Çalışmaya alınan 199 hastanın anormal tomografi bulgusu ile CRP ve lökosit yüksekliği arasında anlamlı ilişki bulundu. Tomografi ve CRP’nin taburculuk ve yatış oranını etkilediği görüldü. Tomografi bulgusu ve CRP birlikte kullanıldığında, operasyon kararını etkilediği bulundu. Sonuç: Çalışmamıza göre; karın ağrısında CRP yüksekliği, anormal tomografi bulgusunu ön görebilir ve lökositten daha değerlidir. Tomografi ve CRP birlikte kullanıldığında operasyon kararı etkilenmektedir.

References

  • Strömberg C, Johansson G, Adolfsson A. Acute Abdominal Pain: Diagnostic Impact of Immediate CT Scanning. World J Surg. 2007;31:2347–54
  • Scheinfeld MH, Mahadevia S, Stein EG, Freeman K, Rozenblit AM. Can lab data be used to reduce abdominal computed tomography (CT) usage in young adults presenting to the emergency department with nontraumatic abdominal pain?. Emerg Radiol. 2010;17:353–60
  • Keijzers GB, Britton CJ. Doctors’ knowledge of patient radiation exposure from diagnostic imaging requested in the emergency department. Med J Aust. 2010;193:450–3.
  • Clyne B, Olshaker JS. The C-reactive protein. J Emerg Med. 1999;17:1019-25.
  • Tamanna MZ, Eram U, Al Harbi TM, Alrashdi SA, Khateeb SU, Aladhrai SA et al. Clinical value of leukocyte counts in evaluation of patients with suspected appendicitis in emergency department. Ulus Travma Acil Cerrahi Derg. 2012;18:474-8.
  • Gore RM, Miller FH, Pereles FS, Yaghmai V, Berlin JW. Helical CT in the evaluation of the acute abdomen. AJR Am J Roentgenol. 2000;174:901–13.
  • Rosen MP, Siewert B, Sands DZ, Bromberg R, Edlow J, Raptopoulos V. Value of abdominal CT in the emergency department for patients with abdominal pain. Eur Radiol. 2003;13:418–24.
  • Ng CS, Watson CJ, Palmer CR, See TC, Beharry NA, Housden BA et al. Evaluation of early abdominopelvic computed tomography in patients with acute abdominal pain of unknown cause: prospective randomized study. BMJ. 2002;325:1387– 95.
  • Lee J, Kirschner J, Pawa S, Wiener DE, Newman DH, Shah K. Computed Tomography Use in the Adult Emergency Department of an Academic Urban Hospital From 2001 to 2007. Ann Emerg Med. 2010;56:591-6.
  • Hastings RS, Powers RD. Abdominal pain in the ED: a 35 year retrospective. Am J Emerg Med. 2011;29:711–6.
  • Frei SP, Bond WF, Bazuro RK, Richardson DM, Sierzega GM, Reed JF. Appendicitis outcomes with increasing computed tomographic scanning. Am J Emerg Med. 2008;26:39-44.
  • Abujudeh HH, Kaewlai R, McMahon PM, Binder W, Novelline RA, Gazelle GS et al. Abdominopelvic CT Increases Diagnostic Certainty and Guides Management Decisions: A Prospective Investigation of 584 Patients in a Large Academic Medical Center. AJR Am J Roentgenol. 2011;196:238–43.
  • Rosen MP, Sands DZ, Longmaid HE 3re, Reynolds KF, Wagner M, Raptopoulos V. Impact ofabdominal CT on the management of patients presentingto the emergency department with acute abdominal pain. AJR Am J Roentgenol. 2000;174:1391–6.
  • Lewis LM, Klippel AP, Bavolek RA, Ross LM, Scherer TM, Banet GA. Quantifying the usefulness of CT in evaluating seniors with abdominal pain. Eur J Radiol. 2007;61:290–6.
  • Coyle JP, Brennan CR, Parfrey SF, O'Connor OJ, Mc Laughlin PD, Mc Williams SR et al. Is serum C- reactive protein a reliable predictor of abdomino- pelvic CT findings in the clinical setting of the non- traumatic acute abdomen?. Emerg Radiol. 2012;19:455-62.
  • Chi CH, Shiesh SC, Chen KW, Wu MH, Lin XZ. C- reactive protein for the evaluation of acute abdominal pain. Am J Emerg Med. 1996;14:254-6.
There are 16 citations in total.

Details

Primary Language English
Journal Section Research
Authors

Yeliz Şimşek This is me

Salim Satar This is me

Derya Karasu This is me

Publication Date October 2, 2015
Published in Issue Year 2015 Volume: 40 Issue: 4

Cite

MLA Şimşek, Yeliz et al. “Significance of Tomography and CRP in Abdominal Pain Management”. Cukurova Medical Journal, vol. 40, no. 4, 2015, pp. 766-73, doi:10.17826/cutf.94425.