Evidence map›Paper›PMID 39871387›Full record

Observational studyScandinavian journal of trauma, resuscitation and emergency medicine2025

Significant room for improvement in the prehospital assessment and treatment of acute abdominal pain: a retrospective observational study.

Rasmus Bjerén, Carl Magnusson, Johan Herlitz, Denise Bäckström

Abstract readObservational Study
In one paragraph

Observational study in Scandinavian journal of trauma, resuscitation and emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Rasmus BjerénCenter for Research and Development, Region Gävleborg, Gävle, Sweden.
Carl MagnussonDepartment of Prehospital Emergency Care, Sahlgrenska University Hospital, Gothenburg, Sweden.
Johan HerlitzCenter for Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.
Denise BäckströmDepartment of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden. denise.backstrom@liu.se.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute abdominal pain (AAP) is a common reason for calling emergency medical services (EMS). Despite the widely acknowledged importance of effective prehospital pain management, described by patients as crucial regardless of any other factor, studies on prehospital pain management in AAP patients are limited and suggest room for improvement. This is particularly relevant given the long-standing controversy surrounding the use of analgesia in AAP patients before a final diagnosis is made, which may still influence the prehospital pain management.

methodsA retrospective cohort study of pain management in EMS patients with AAP in a central Swedish region. The region had a population density of 15.7 inhabitants per square kilometer spread over a mix of small urban and rural settings. Patient records were manually reviewed and scanned for written assessments or numeric ratings of pain. The analysis focused on proportions of assessment, treatment and reassessment of pain as well as median pain intensity, pain reduction and proportion of patients with a low last recording of pain.

results816 patients were included. Pain was assessed in 55% (n = 447) of all cases. The median initial pain intensity was eight units (IQR 6.0-9.0) on the Numerical Rating Scale (NRS), and 90% (n = 403) of the assessed patients experienced moderate or severe pain. Of those, 62% (n = 249) received pharmacological treatment. In 50% (n = 158) of all cases receiving treatment, pain was reassessed afterwards. The median pain reduction was four units (IQR 2.0-5.0) on the NRS scale. Among all cases, 10% (n = 84) had a last recorded pain assessment indicating low pain.

conclusionsSignificant room for improvement in the prehospital management of acute abdominal pain was found. The proportions of pain assessment, treatment and reassessment were low with nine out of ten patients leaving prehospital care with unknown, moderate or severe pain. Among the cases where pain assessment, treatment and reassessment were made and recorded, four out of five patients experienced significant pain relief, indicating the potential of better prehospital pain management.

Indexed as

Abdominal PainEmergency Medical ServicesPain ManagementPain MeasurementAdultAgedFemaleHumansMaleMiddle AgedRetrospective StudiesSwedenAbdominal painAcute painEmergency medical servicesPainPain managementPain measurement

Identifiers

PMID39871387
PMCPMC11773934

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.