ArticleQatar medical journal2026
Nonspecific abdominal pain (NSAP): Ten-year retrospective analysis of recurrence, diagnostic outcomes, imaging yield, and healthcare costs.
Article in Qatar medical journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
Objectives: Nonspecific abdominal pain (NSAP) is a frequent emergency presentation characterized by diagnostic uncertainty, recurrent healthcare utilization, and variable imaging strategies. We aimed to evaluate long-term diagnostic trajectories, recurrence patterns, mortality, direct hospital costs, and the diagnostic yield of abdominal imaging (computed tomography abdomen and pelvis [CTAP] and ultrasound [USS]) in a large UK cohort. Methods: We conducted a retrospective observational study of 1171 patients presenting with NSAP to a UK district general hospital over 10 years, with a 2-year follow-up. Data included demographics, investigations, recurrence, diagnostic progression, mortality, and direct hospital costs. Predictors of recurrence were assessed using multivariable logistic regression. Results: The mean age was 46.3 years, and 62% were female. At 2 years of follow-up, 71.2% remained without a confirmed diagnosis, and 33.4% experienced recurrence of NSAP. Recurrence was significantly higher among patients who ultimately received a diagnosis (53.1%) compared with those who remained undiagnosed (25.4%; P < 0.001). Prior similar abdominal pain was the strongest independent predictor of recurrence (adjusted odds ratio, 4.0 [95% CI, 3.1-5.3]; P < 0.001). CTAP was performed in 390 patients; reports were available for 347 (89.0%), of which 39.8% were abnormal. CTAP led to further clinical actions in 34.9% and contributed to a confirmed diagnosis in 34.6%. USS was performed in 354 patients; reports were available for 297 (83.9%), of which 9.8% were abnormal. USS led to further clinical actions in 5.6% and contributed to a confirmed diagnosis in 5.4%.Two-year mortality was 8.7%, with malignancy accounting for 12.5% of confirmed diagnoses and 24.5% of recorded causes of death. Recurrence-related direct hospital costs totaled approximately £469,955 over 2 years. Conclusion: NSAP is associated with high diagnostic uncertainty, frequent recurrence, and substantial resource use. CTAP demonstrates meaningful diagnostic yield and commonly contributes to actionable management and diagnostic clarification, supporting structured pathways with targeted imaging and follow-up, while recognizing limitations of retrospective electronic health record capture.
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