Clinical Presentations and Surgical Outcomes in Patients With Nontraumatic Acute Abdominal Pain: A Prospective Analysis

非创伤性急性腹痛患者的临床表现和手术结果:一项前瞻性分析

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Abstract

BACKGROUND:  Nontraumatic acute abdominal pain is a common presentation in emergency settings, often requiring surgical intervention. This study aimed to explore the clinical presentations, surgical management, and outcomes in patients with nontraumatic acute abdominal pain, providing insights for improving management strategies. METHODS: This observational study was conducted at a tertiary care hospital in North India and included 433 patients who underwent elective and emergency abdominal surgeries from June 2021 to May 2023. Data were collected on patient demographics, comorbidities, duration of symptoms, initial presenting symptoms, and surgical procedures performed. Laboratory parameters were assessed preoperatively, and postoperative outcomes, including complications, recovery metrics, and length of hospital stay, were recorded. Statistical analyses, including logistic regression, were utilized to determine the adjusted odds ratios for significant predictors of complications. RESULTS:  A total of 433 patients were included in the analysis, with a mean age of 42.3 ± 12.1 years. The study revealed that 5.5% of patients experienced complications, with wound infections (3.0%) and intra-abdominal abscesses (0.9%) being the most common. Recovery metrics indicated that the mean time to resume oral intake was 2.5 ± 1.2 days, the time to first bowel movement was 3.0 ± 1.5 days, and the duration of the postoperative hospital stay averaged 5.0 ± 2.0 days. Logistic regression analysis identified significant predictors of complications, including diabetes mellitus (adjusted OR, 2.02; p < 0.001), hypertension (adjusted OR, 1.44; p = 0.025), and intraoperative findings such as appendiceal perforation (adjusted OR, 2.14; p < 0.001). CONCLUSION:  The study underscores the critical role of timely diagnosis and appropriate surgical management in patients with nontraumatic acute abdominal pain. Recognizing high-risk factors, such as diabetes and elevated American Society of Anesthesiologists scores, can enhance surgical decision-making and improve patient outcomes. These findings advocate for refined management protocols and a multidisciplinary approach to optimize care for patients presenting with acute abdominal pain.

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