Clinical spectrum of intra-abdominal abscesses in patients admitted to the emergency department

Abstract

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. (C) 2020 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.