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Master Thesis

Évaluation de la gravité des patients âgés de plus de 75 ans admis aux urgences pour douleur abdominopelvienne ou lombaire : étude comparative à partir des données de l’étude EpiAbdo

Abstract : Background: the aim of our study was to compare the severity of patients over and under 75 years old admitted in emergency departments (ED) for abdominal pain, and comparing their management. Methods: based on the prospective, observational, multicenter EpiAbdo study. 1006 files could be analyzed. Chi-square, Fisher and Student tests were used to compare the two populations. An a risk <5% (p <0.05) was considered significant. Results: subjects older than 75 are more hospitalized (66% vs 26% p<0.001) and the mortality rate is higher (6% vs 1% p<0.001). They have more comorbidities (98% vs 58% p<0.001) and treatments (96% vs 32% p<0.001). They are more often referred (65% vs 31% p<0.001) and arrive with an ambulance (60% vs. 10% p<0.01). They are less painful (NRS=4.8 vs 5.5 p=0.04), but have more associated symptoms (74% vs 54% p <0.001) including signs of severity. An analgesic is more often administered by intravenous way (86% vs 71% p=0.001) and the patients are relieved at the end of care (81%). The most common diagnosis, regardless of age, is nonspecific abdominal pain. In the over-75 group, more serious diagnoses were found, such as occlusions (7% vs 1.6%, p<0.001) or angiocholitis (2.1% vs 0.5%, p=0.009). The over-75 have a longer average length of stay (6h33min vs 4h45min, p<0.001). 30 days after their visit to the emergency department, subjects over 75 are less likely to be back at home (84% vs. 95%, p=0.01). Conclusions: patients over 75 admitted in ED for abdominal pain are more serious. This could be explained by the different terrain but also by differences in the management of these patients.
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Matthieu Cournol. Évaluation de la gravité des patients âgés de plus de 75 ans admis aux urgences pour douleur abdominopelvienne ou lombaire : étude comparative à partir des données de l’étude EpiAbdo. Médecine humaine et pathologie. 2019. ⟨dumas-02510557⟩

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