621 Acute exacerbation of chronic abdominal pain: A multicenter prospective observational study

Document Type

Conference Proceeding

Publication Date

5-13-2024

Publication Title

Acad Emerg Med

Abstract

Background and Objectives: Abdominal pain is the most frequent chief complaint in US emergency departments (EDs) accounting for over 6?million annual visits. Some ED episodes of recurrent abdominal pain are due to Disorders of Gut-Brain Interaction (DGBI). As part of a multicenter prospective observational study, our objective was to characterize biopsychosocial characteristics of ED patients with DGBI including substance use disorder, mental health, social determinants of health, overall healthcare utilization and 30-day revisits. Methods: The study was conducted at three US university ED's. Adult patients were eligible if they presented to the ED with a chief complaint relating to abdominal pain lasting at least once per week for 8?weeks. Patients were excluded if a structural cause for their symptoms was suspected. Using validated scoring systems, patient reported outcomes were measured for anxiety, depression, fatigue, and pain interference. Substance use disorder risks were measured using the WHO ASSIST Instrument, and social needs were recorded using the AHC-HRSN Instrument. At 30?days after index visit, structured chart reviews were conducted to assess ED revisits. Results: Seventy-two patients were enrolled in the study between February and November 2023 with a mean age of 39.0, 62.0% female and 64.8% Black. PROMIS scores more than one standard deviation above the mean were observed in categories of pain interference (n?=?40, 55.6%), fatigue (n?=?33, 45.8%), depression (n?=?19, 26.4%), and anxiety (n?=?28, 38.9%). Forty-six (63.9%) patients reported that abdominal pain interfered with day-to-day activities “very much” or “quite a bit” in the past 7?days. High social risks were also reported in physical activity (n?=?46, 63.9%), financial strain (n?=?28, 38.9%), and food insecurity (n?=?27, 37.5%). High or moderate risk substance abuse was detected in 40 participants (55.6%). Nine participants (12.5%) received opioids as a prescription at the index visit and nine (12.5%) returned to the ED within 30?days. Conclusion: This study enhances understanding of biopsychosocial factors associated with ED visits in patients with DGBI, with notable findings of a high rate of women, comorbid anxiety/depression, and several prevalent needs. Given the observed rates of ED revisits and opioid prescriptions within 30-day review, further studies should seek to better classify this patient population and develop potential treatment plans.

Volume

31

Issue

S1

First Page

186

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