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Clinical Trial
. 2002 Dec 14;325(7377):1387.
doi: 10.1136/bmj.325.7377.1387.

Evaluation of early abdominopelvic computed tomography in patients with acute abdominal pain of unknown cause: prospective randomised study

Chaan S Ng  1 , Christopher J E Watson, Christopher R Palmer, Teik Choon See, Nigel A Beharry, Barbara A Housden, J Andrew Bradley, Adrian K Dixon
Affiliations
Clinical Trial

Evaluation of early abdominopelvic computed tomography in patients with acute abdominal pain of unknown cause: prospective randomised study

Chaan S Ng et al. BMJ. .

Abstract

Objectives: To evaluate the impact of early abdominopelvic computed tomography in patients with acute abdominal pain of unknown cause on length of hospital stay and accuracy of diagnosis.

Design: Randomised, prospective controlled trial.

Setting: Teaching hospital in England.

Participants: 120 patients admitted with acute abdominal pain for which no immediate surgical intervention or computed tomography was indicated.

Intervention: 55 participants were prospectively randomised to early computed tomography (within 24 hours of admission) and 65 to standard practice (radiological investigations as indicated).

Main outcome measures: Length of hospital stay, accuracy of diagnosis, and, owing to a possible effect on inpatient mortality, deaths during the study.

Results: Early computed tomography reduced the length of hospital stay by 1.1 days (geometric mean 5.3 days (range 1 to 31) v 6.4 days (1 to 60)), but the difference was non-significant (95% confidence interval, 8% shorter stay to 56% longer stay, P=0.17). Early computed tomography missed significantly fewer serious diagnoses. Seven inpatients in the standard practice arm died. Only 50% (59 of 118) of diagnoses on admission were correct at follow up at 6 months, but this improved to 76% (90) of diagnoses after 24 hours.

Conclusions: Early abdominopelvic computed tomography for acute abdominal pain may reduce mortality and length of hospital stay. It can also identify unforeseen conditions and potentially serious complications.

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Figures

Figure
Figure
Flow of patients through trial. *Number of admitting diagnoses correct at follow up; †number of diagnoses at 24 hours correct at follow up
See this image and copyright information in PMC

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