TY - JOUR
T1 - Clinical spectrum of intra-abdominal abscesses in patients admitted to the emergency department
AU - Kim, Keon
AU - Kim, Eun
AU - Lee, Jae Hee
N1 - Publisher Copyright:
© 2020 College of Emergency Nursing Australasia
PY - 2020/3
Y1 - 2020/3
N2 - Background: The mortality of undrained abdominal abscesses may be as high as 35 %. In this study, we analyzed the clinical spectrum of intra-abdominal abscess (IAA) patients in the ED and attempted to identify factors that can predict the severity of IAA. Method: This study was a retrospective review of adults (≥ 18 years) with IAA admitted to a single ED. IAA were diagnosed by abdominal computed tomography. The differences in clinical variables between patients receiving and not receiving inotropic drugs were analyzed. Multiple logistic regression was performed for assessing predictor variables. Results: 128 patients presented with IAA. The most common complaint was abdominal pain (60.2 %) and the liver was most common location (39.8 %). Patients who required inotropic drugs had lower serum leukocyte, lymphocyte, and platelet counts and higher serum BUN and CRP levels. The independent factors associated with need for inotropic drugs were serum leukocyte, CRP, and BUN level. The optimal cutoff CRP value for predicting inotropic drug use was 12.06 mg/dL, BUN value was 21 mg/dL. Conclusions: Elevated CRP and BUN levels could predict a higher association with requirement of inotrope. Therefore, emergency physicians should consider CRP and BUN levels and aiming for early aggressive treatment.
AB - Background: The mortality of undrained abdominal abscesses may be as high as 35 %. In this study, we analyzed the clinical spectrum of intra-abdominal abscess (IAA) patients in the ED and attempted to identify factors that can predict the severity of IAA. Method: This study was a retrospective review of adults (≥ 18 years) with IAA admitted to a single ED. IAA were diagnosed by abdominal computed tomography. The differences in clinical variables between patients receiving and not receiving inotropic drugs were analyzed. Multiple logistic regression was performed for assessing predictor variables. Results: 128 patients presented with IAA. The most common complaint was abdominal pain (60.2 %) and the liver was most common location (39.8 %). Patients who required inotropic drugs had lower serum leukocyte, lymphocyte, and platelet counts and higher serum BUN and CRP levels. The independent factors associated with need for inotropic drugs were serum leukocyte, CRP, and BUN level. The optimal cutoff CRP value for predicting inotropic drug use was 12.06 mg/dL, BUN value was 21 mg/dL. Conclusions: Elevated CRP and BUN levels could predict a higher association with requirement of inotrope. Therefore, emergency physicians should consider CRP and BUN levels and aiming for early aggressive treatment.
KW - Abdominal abscess
KW - Emergency department
KW - Intra-abdominal abscess
UR - http://www.scopus.com/inward/record.url?scp=85077661592&partnerID=8YFLogxK
U2 - 10.1016/j.auec.2019.12.009
DO - 10.1016/j.auec.2019.12.009
M3 - Article
C2 - 31926960
AN - SCOPUS:85077661592
SN - 2589-1375
VL - 23
SP - 6
EP - 10
JO - Australasian Emergency Care
JF - Australasian Emergency Care
IS - 1
ER -