EVALUATION OF GERIATRIC PATIENTS THAT ADMITTED TO THE EMERGENCY DEPARTMENT WITH ACUTE ABDOMINAL PAIN

Öz

Objective The goal of the study is to investigate demographic findings, clinical characteristics, radiological examination methods, and mortality rate of geriatric patients (aged 65 and above) with non-traumatic acute abdominal pain, that were admitted to the emergency department (ED). Materials and Methods 2253 patients included in the study were divided by age as patients aged 65 to 74 years and patients aged 75 years and above. Gender, comorbidity, concomitant complaints examination findings (tenderness defense, rebound), radiological examination methods (radiography, ultrasonography, and computed tomography), diagnoses, treatments (medical, surgical), discharge, and mortality rate were compared between these patients. Results Of the patients, 62.3% were female, and the mean age was 72.2±5.1 years (65-88). While 59.4% of the patients were in the 65–74 age group, 40.6% of them were aged 75 years and above. Hypertension, diabetes mellitus, dementia/Alzheimer's disease, atrial fibrillation were significantly higher in the aged 65 to 74 years patients (p<0.001). Diarrhea, one of the concomitant complaints, was significantly higher in the aged 65 to 74 years patients (p<0.001). Tenderness, defense, and rebound were significantly higher in the aged 65 to 74 years patients (p<0.001). There was no difference between the age ranges in terms of radiological examination methods (p=0.434; p=0.321; p=0.634, respectively). Acute gastroenteritis, nonspecific abdominal pain, abdominal aortic aneurysm were higher in the aged 65 to 74 years patients, while biliary and biliary tract diseases, constipation, gastrointestinal tract bleeding, peptic ulcer, diverticulitis and complications, stomach perforation, abdominal aortic dissection, and acute mesenteric ischemia were higher in the aged 75 years and above (p<0.05). There was no difference between the age groups in terms of treatment (p=0.478; p=0.182, respectively). The number of patients who died aged 75 years and above was significantly higher (p<0.001). Conclusion The current study found significant age-related differences in examination findings, diseases affecting mortality, and mortality rate in geriatric patients admitted to ED with acute abdominal pain.

Anahtar Kelimeler

• Abdominal pain
• geriatric patient
• emergency department

ACİL SERVİSE AKUT KARIN AĞRISI İLE BAŞVURAN GERİATRİK HASTALARIN DEĞERLENDİRİLMESİ

Öz

Amaç Bu çalışmanın amacı acil servise (AS) nontravmatik akut karın ağrısı ile başvuran 65 yaş ve üzeri geriatrik hastaların demografik bulgularını, klinik özelliklerini, radyolojik inceleme yöntemlerini ve mortalite oranlarını değerlendirmektir. Gereç ve Yöntem Çalışmaya dahil edilen 2253 hasta yaş aralıklarına göre; 65-74 ve 75 yaş ve üzeri olarak ayrıldı. Cinsiyet, komorbidite, eşlik eden şikayetler, muayene bulguları (hassasiyet, defans, rebound), radyolojik inceleme yöntemleri (radyografi, ultrasonografi ve bilgisayarlı tomografi), tanılar, tedaviler (tıbbi, cerrahi), taburculuk ve mortalite oranları karşılaştırıldı. Bulgular Hastaların %62.3'ü kadın olup, yaş ortalaması 72.2±5.1 yıl (65-88) idi. Hastaların %59,4'ü 65-74 yaş aralığında iken, %40,6'sı 75 yaş ve üzerinde idi. Hipertansiyon, diabetes mellitus, demans/Alzheimer hastalığı, atriyal fibrilasyon 65-74 yaş aralığındaki hastalarda anlamlı olarak daha yüksekti (p<0,001). Eşlik eden yakınmalardan biri olan ishal, 65-74 yaş aralığındaki hastalarda anlamlı olarak daha yüksek idi (p<0,001). Hassasiyet, defans ve rebound, 65-74 yaş aralığındaki hastalarda anlamlı olarak daha yüksek idi. (p<0.001). Radyolojik inceleme yöntemleri açısından yaş aralıkları arasında fark yok idi (sırasıyla; p=0,434; p=0,321; p=0,634). 65-74 yaş aralığındaki hastalarda akut gastroenterit, nonspesifik karın ağrısı, abdominal aort anevrizması, 75 yaş ve üzerinde safra kesesi ve yollarına ait hastalıklar, konstipasyon, gastrointestinal sistem kanaması, peptik ülser, divertikülit ve komplikasyonları, mide perforasyonu, abdominal aorta diseksiyonu ve akut mezenterik iskemi tanıları anlamlı yüksek idi (p<0,05). Tedavi açısıdan yaş aralıkları arasında anlamlı fark saptanmadı (sırasıyla; p=0,478; P=0,182). 75 yaş ve üzerinde ölen hasta sayısı anlamlı olarak daha yüksek idi (p<0,001). Sonuç Mevcut çalışma, AS’e akut karın ağrısı ile başvuran geriatrik hastalarda muayene bulguları, mortaliteyi etkileyen hastalıklar ve mortalite oranlarında yaşa bağlı anlamlı farklılıklar bulmuştur.

Anahtar Kelimeler

• Karın ağrısı
• geriatrik hasta
• acil servis

Kaynakça

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