Diagnostic accuracy of symptoms, signs and one-year prognosis of patients with acute non-specific abdominal pain:: prospective survey

BACKGROUND The aims of this study were to determine the diagnostic value of elements of the disease history, the clinical findings and basic laboratory examinations in differential diagnosis of the patients with nonspecific abdominal pain and to analyze the long-term survey of these patients. METHODS A prospective observational study was performed at the Department of General Surgery Medicine Faculty of Uludag University between November 2001 to November 2002. Based on the diagnosis reasons for abdominal pain, 610 patients were classified as being of specific abdominal pain (n=501) versus nonspecific abdominal pain (n=109). Patients with nonspecific abdominal pain were invited to a follow-up examination 24 hours later and 4 follow-up interviews were conducted on days 8, 15, 30 and at the end of I year. Statistical analyses were performed between findings of two groups. RESULTS In logistic regression analysis, presence of a history of similar pain (odds ratio 1.88; p=0.009), nausea (odds ratio 0.46; p=0.001), rigidity (odds ratio 0.24; p=0.024), fever <= 36.6 degrees C (odds ratio 1.66; p=0.037), leukocyte count <= 8700 (odds ratio 1.85; p=0.011), age <= 39 years (odds ratio 1.85; p=0.018), respiratory rate <= 15 (odds ratio 3.19; p=0.00..) were significantly independent diagnostic factors. There was no malignancy during one-year follow-up period. CONCLUSION The possibility of a specific cause is higher in patients with history of a similar pain, nausea, rigidity, fever >36.6 degrees C, leukocyte count >8700, age >39 years, respiratory rate >15 in admission and persistent pain 24 hours after discharge.