@article{fdi:010062504,
  title = {{T}riage using a self-assessment questionnaire to detect potentially life-threatening emergencies in gynecology},
  author = {{H}uchon, {C}. and {D}umont, {A}lexandre and {C}hantry, {A}. and {F}alissard, {B}. and {F}auconnier, {A}.},
  editor = {},
  language = {{ENG}},
  abstract = {{O}bjective: {A}cute pelvic pain is a common reason for emergency room visits that can indicate a potentially life-threatening emergency ({PLTE}). {O}ur objective here was to develop a triage process for {PLTE} based on a self-assessment questionnaire for gynecologic emergencies ({SAQ}-{GE}) in patients experiencing acute pelvic pain. {M}ethods: {I}n this multicenter prospective observational study, all gynecological emergency room patients seen for acute pelvic pain between {S}eptember 2006 and {A}pril 2008 completed the {SAQ}-{GE} after receiving appropriate analgesics. {D}iagnostic procedures were ordered without knowledge of questionnaire replies. {L}aparoscopy was the reference standard for diagnosing {PLTE}; other diagnoses were based on algorithms. {I}n two-thirds of the population, {SAQ}-{GE} items significantly associated with {PLTE}s ({P} < 0.05) by univariate analysis were used to develop a decision tree by recursive partitioning; the remaining third served for validation. {R}esults: {O}f 344 derivation-set patients and 172 validation-set patients, 96 and 49 had {PLTE}s, respectively. {I}tems significantly associated with {PLTE}s were vomiting, sudden onset of pain, and pain to palpation. {S}ensitivity of the decision tree based on these three features was 87.5% (95% confidence interval (95% {CI}), 81%-94%) in the derivation set and 83.7% in the validation set. {D}erivation of the decision tree provided probabilities of {PLTE} of 13% (95% {CI}, 6%-19%) in the low-risk group, 27% (95% {CI}, 20%-33%) in the intermediate-risk group and 62% (95% {CI}, 48%-76%) in the high-risk group, ruling out {PLTE} with a specificity of 92.3%; (95% {CI}, 89%-96%). {I}n the validation dataset, {PLTE} probabilities were 16.3% in the low-risk group, 30.6% in the intermediate-risk group, and 44% in the high-risk group, ruling out the diagnosis of {PLTE} with a specificity of 88.6%. {C}onclusion: {A} simple triage model based on a standardized questionnaire may assist in the early identification of patients with {PLTE}s among patients seen in the gynecology emergency room for acute pelvic pain.},
  keywords = {{G}ynecologic emergencies ; {T}riage ; {S}ensitivity ; {Q}uestionnaire ; {FRANCE}},
  booktitle = {},
  journal = {{W}orld {J}ournal of {E}mergency {S}urgery},
  volume = {9},
  numero = {},
  pages = {art. 46 [6 ]},
  ISSN = {1749-7922},
  year = {2014},
  DOI = {10.1186/1749-7922-9-46},
  URL = {https://www.documentation.ird.fr/hor/fdi:010062504},
}