“Acute abdomen”: comparison of diagnoses of emergency medical teams and emergency hospital

The problems of the quality of diagnostics at the prehospital stage remain relevant. Diagnostic errors represent an urgent medical and social problem. The purpose of the study was to study the continuity in the provision of medical care to patients with acute surgical pathology of the abdominal organs in terms of the coincidence of the diagnoses of the emergency medical teams and the emergency hospital. The statistical data of the State Budgetary Institution St. Petersburg Research Institute of Emergency Medicine named after I. I. Dzhanelidze for the period 2015–2022, content analysis, statistical and analytical methods were used. Study results. Among patients with acute surgical pathology of the abdominal organs, a significant discrepancy in the diagnoses of prehospital and inpatient stages was revealed: “acute cholecystitis” in the diagnosis of emergency medical teams was confirmed by the hospital in 51.2% of cases, “ectopic pregnancy” — in 28.9% of cases, “acute appendicitis” — in 20.7% of cases, “acute pancreatitis” — in 6.7% of cases, “acute intestinal obstruction — in 5.7% of cases,” perforative ulcer” — in 3.1% of cases. 36.1% of patients received an unverified diagnosis of acute abdominal surgical pathology. Conclusion. Defects in the formulation, execution or coding of a diagnosis — an indicator of unsatisfactory qualifications of a medical worker and the quality of the organization of the medical and diagnostic process. It is the diagnosis, as an integral indicator of the clinical thinking of a doctor (paramedic), that is of exceptional importance, since it performs cognitive-logical, scientific, statistical and legal functions. However, reasonable overdiagnosis in the prehospital stage of emergency medical care is welcome, as underestimating the severity of the condition in conditions of limited diagnostic capacity and time deficit can have severe consequences for the patient.The tasks of clarifying the diagnosis, determining the indications for hospitalization and further tactics are designed to solve inpatient emergency departments with real medical and diagnostic, material and technical and personnel resources.

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