Diagnostic outcomes following childhood non-specific abdominal pain: a record-linkage study.
Arch Dis Child
; 101(4): 305-9, 2016 Apr.
Article
in En
| MEDLINE
| ID: mdl-26220924
ABSTRACT
AIMS:
Non-specific abdominal pain (NSAP) is the most common diagnosis on discharge following admission for abdominal pain in childhood. Our aim was to determine the risk of subsequent hospital diagnosis of organic and functional gastroenterological conditions following a diagnosis of NSAP, and to assess the persistence of this risk.METHODS:
An NSAP cohort of 268,623 children aged 0-16â years was constructed from linked English Hospital Episode Statistics from 1999 to 2011. The control cohort (1,684,923 children, 0-16â years old) comprised children hospitalised with unrelated conditions. Clinically relevant outcomes were selected and standardised rate ratios were calculated.RESULTS:
From the NSAP cohort, 15,515 (5.8%) were later hospitalised with bowel pathology and 13,301 (5%) with a specific functional disorder. Notably, there was a 4.84 (95% CI 4.45 to 5.27) times greater risk of Crohn's disease following NSAP and a 4.23 (4.13 to 4.33) greater risk of acute appendicitis than in the control cohort. The risk of irritable bowel syndrome (IBS) was 7.22 (6.65 to 7.85) times greater following NSAP. The risks of inflammatory bowel disease (IBD), IBS and functional disorder (unspecified) were significantly increased in all age groups except <2-year-olds. The risk of underlying bowel pathology remained raised up to 10â years after first diagnosis with NSAP.CONCLUSIONS:
Only a small proportion of those with NSAP go on to be hospitalised with underlying bowel pathology. However, their risk is increased even at 10â years after the first hospital admission with NSAP. Diagnostic strategies need to be assessed and refined and active surveillance employed for children with NSAP.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Abdominal Pain
/
Medical Record Linkage
/
Hospitalization
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
Country/Region as subject:
Europa
Language:
En
Journal:
Arch Dis Child
Year:
2016
Document type:
Article
Affiliation country:
United kingdom