Evidence map›Paper›PMID 40898025›Full record

ArticleInternational journal of emergency medicine2025

Characteristics of patients with ruptured abdominal aortic aneurysm who contacted out-of-hours primary care: a case-control study.

Carline J van den Dries, Dave A Dongelmans, Maarten J van der Laan, Sonja Oomkens, Eva Ouwendijk, Annelies Visser, Frans H Rutten, Dorien L M Zwart

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of 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. Yonder: Principlistic equality, rejected referrals, ruptured AAAs in out of hours, and Kickstart patient movement.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025
    Article
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

8 authors.

Carline J van den DriesDepartment of General Practice & Nursing Science, Julius Center for Health Sciences and Primary care, University Medical Center Utrecht, Utrecht University, P.O. Box 85500, Utrecht, 3508 AB, The Netherlands. c.j.vandendries@umcutrecht.nl.
Dave A DongelmansDepartment of Intensive Care Medicine, Amsterdam UMC, Amsterdam Public Health, University of Amsterdam, Amsterdam, Netherlands.
Maarten J van der LaanDepartment of Surgery, University Medical Centre Groningen, Groningen, The Netherlands.
Sonja OomkensFounder of 'Veiliger Zorg', De Meern, The Netherlands.
Eva OuwendijkUrgent Care Team, NEO Regional Primary Care Organization, Nijmegen, The Netherlands.
Annelies VisserDepartment of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Frans H RuttenDepartment of General Practice & Nursing Science, Julius Center for Health Sciences and Primary care, University Medical Center Utrecht, Utrecht University, P.O. Box 85500, Utrecht, 3508 AB, The Netherlands.
Dorien L M ZwartDepartment of General Practice & Nursing Science, Julius Center for Health Sciences and Primary care, University Medical Center Utrecht, Utrecht University, P.O. Box 85500, Utrecht, 3508 AB, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRuptured abdominal aortic aneurysm (rAAA) is rare but it is the second most frequently missed diagnosis reported as sentinel adverse event ('calamity') at out-of-hours services in primary care (OHS-PC). We aimed to identify characteristics that could be useful for telephone triage of suspected rAAA at the OHS-PC.

methodsIn a matched case-control study (1:4 ratio), we compared patients with a missed rAAA (cases) to patients with the same age and sex, and with similar entrance complaint (controls). Data were collected from OHS-PC triage call recordings that were re-assessed by researchers blinded to the case-control status. Patient and call characteristics were univariably assessed with conditional logistic regression analysis.

resultsTwenty cases of missed rAAA between 2013 and 2023 were matched to 80 controls. 40% of the cases presented with abdominal pain, and 35% with back pain. Cases compared to controls more often had a pain onset < 12 h (odds ratio (OR) 15.2; 95%CI 1.9-123.8), reported more sweating (OR 10.1; 95% CI 1.2-86.9, p = 0.035), more often verbally expressed their concern (OR 13.6; 95%CI 3.0-61.3, p = 0.001), and more often called during the night (OR 3.8; 95% CI 1.1-12.7, p = 0.029).

conclusionsRecognition of rAAA at the OHS-PC remains challenging given its rare occurrence and lack of specific symptoms. Nevertheless, this case-control study identified factors that could be useful in triage of patients calling the OHS-PC with symptoms possibly indicating rAAA.

Indexed as

Emergency medicineOut-of-hours primary care servicesPrimary careRuptured abdominal aortic aneurysmTriage

Identifiers

PMID40898025
PMCPMC12403838

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.