Acute abdominal pain in the emergency department of a university hospital in Italy

Background: Acute abdominal pain (AAP) is one of the most common causes of referral to an emergency department (ED), but information about its impact is limited. Objectives: The objectives of this article are to define the prevalence of AAP among ED visits in a large university hospital and analyze its main clinical features. Methods: All patients admitted at the Sant’Orsola, Malpighi University Hospital of Bologna ED on 12 a priori selected sample days in 2013 were included. General data were recorded for each patient. A total of 192 clinical variables were recorded for each patient with abdominal pain. Results: During the observation period the ED assisted 2623 patients with a daily admission rate of 219 20 (mean SD). Of these, 239 patients complained of AAP as their chief complaint at entry (prevalence = 9.1%). AAP prevalence was significantly higher in females than in males (10.4% vs. 7.8%; OR = 1.37; p = 0.021) as well as in foreign over Italian patients (13.2% vs. 8.5%; OR = 1.64; p = 0.007). The most frequent ED operative diagnoses were non-specific abdominal pain (n = 86, 36.0%) and gastrointestinal (GI) tract-related pain (n = 79, 33.1%; n = 19 upper GI, n = 60 lower GI). Conclusions: AAP is a common cause of referral at EDs. Despite technological advances, non-specific abdominal pain is still the main operative diagnosis.