Demografi og triage af børn med akutte mavesmerter

Forfattere

  • Thomas Purup Aarhus Universitetshospital
  • Jette Møller Ahrensberg Aarhus Universitet
  • Lone Nikolajsen Aarhus Universitet

DOI:

https://doi.org/10.7146/akut.v2i4.110483

Nøgleord:

Børn, akutte mavesmerter, Demografi, Triage, DEPT

Resumé

Formålet med dette studie var primært at beskrive populationen af børn med mavesmerter i de danske akutmodtagelser. Det sekundære formål var at undersøge, om det danske triagesystem viser en tendens til at kunne detektere, hvem der har potentielt livstruende sygdomme (PLS – appendicitis anvendt som indikator), eller omvendt udelukke, hvem der ikke har.

Data for alle børn med ”mave- og flankesmerter” i skadestuen på Aarhus Universitetshospital (AUH) i 2017 er inkluderet i dette retroperspektive kohorte-studie. Børnene kategoriseres efter en række karakteristika (alder, køn mv.), og der er vist grafer over triagefordelingen for hver gruppe.

276 børn er inkluderet. Medianalderen var 12 år, med 46% drenge og 54% piger. De fleste havde stærke smerter (239 patienter; 87%) og 90 børn (33%) havde påvirkede vital-parametre. 148 børn (66%) fik en uspecifik diagnose, mens 94 børn (34%) fik en specifik. Appendicitis blev fundet i alle triagekategorier.

Data viser en tendens til, at en lav triagescore ikke udelukker PLS (som appendicitis). Det kan sammenfattes, at børn med mavesmerter præsenterer sig meget forskelligt, og at vitalparametrene ved ankomst ikke altid afspejler alvorligheden af den tilstand, som barnet indlægges med.

ENGLISH

The main aim of this study was to describe characteristics of children presenting with abdominal pain in a Danish Emergency Department (ED). The secondary aim was to assess if the present triage system in the Danish EDs is indicative of children with potentially life-threatening diseases (PLTD – appendicitis used as indicator).

Data of all children with “abdominal and flank pain” in the ED at Aarhus University Hospital (AUH) during 2017 were included in this retrospective cohort study. Patients were classified according to several characteristics (e.g. age, gender) and graphs of triage distribution were shown and compared.

A total of 276 children were included. Median age was 12 years, with 46% boys and 54% girls. Most patients had severe pain (239 patients, 87%) and 90 patients (33%) had affected vital parameters. A total of 148 patients (66%) got an unspecific diagnosis at discharge, while 94 patients (34%) got a specific diagnosis. Appendicitis was found in all triage categories.

Data show a tendency towards low triage not excluding PLTD (such as appendicitis). Also, data suggest that children with abdominal pain show a great variation in symptoms, and vital parameters at admission does not always reflect the severity of the child’s condition.

Forfatterbiografier

Jette Møller Ahrensberg, Aarhus Universitet

Forskningsansvarlig overlæge, Fælles AKUT Afdeling, Ph. D. AUH

Institut for Klinisk Medicin - Center for Akutforskning.

Lone Nikolajsen, Aarhus Universitet

Lærestolsprofessor i anæstesi

Dr. Med, speciallæge i anæstesi

Institut for Klinisk Medicin - Anæstesiologisk afdeling.

Referencer

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Balachandran B., Singhi S. et Lal S. 2013. “Emergency Management of Acute Abdomen in children”. Indian J Pedatr, vol. 80, no. 3, pp. 226-234. DOI: 10.1007/s12098-013-0991-1

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Tsalkidis et al. 2008. “Acute abdomen in children due to extra-abdominal causes”. Pediatrics international, vol. 50, pp. 315-318. DOI: 10.1111/j.1442-200X.2008.02578.x

Loening-Baucke V, Swidsinski. 2007. “Constipation as Cause of Acute Abdominal Pain in Children”. J. Pediatrics, vol. 151, pp. 666-669. DOI: 10.1016/j.jpeds.2007.05.006

Reynolds S.L, Jaffe D.M. 1992. “Diagnosing abdominal pain in a pediatric emergency department”. Pediatric Emergency Care, vol. 8, no. 3, pp. 126-128.

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Publiceret

05-07-2019

Citation/Eksport

Purup, T., Ahrensberg, J. M., & Nikolajsen, L. (2019). Demografi og triage af børn med akutte mavesmerter. Dansk Tidsskrift for Akutmedicin, 2(4), 56–61. https://doi.org/10.7146/akut.v2i4.110483

Nummer

Sektion

Original-, udviklings- og kvalitetsartikler