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Abstract
Laboratory medicine plays a fundamental role in patient care, especially in emergency
departments, where rapid diagnosis is critical to the efficient management of high patient
volumes. In order to simplify and standardise laboratory requests, laboratory profiles have widely been established. This study uses the laboratory profile for "acute abdominal pain" as an example to show the extent to which the laboratory profiles used in hospitals differ from each other and whether they are in line with current scientific recommendations.
In this study the laboratory profiles for “acute abdominal pain" from a total of 18 hospitals, including nine from Germany and nine from Switzerland, were analysed and compared. The hospitals were categorised by bed capacity, inpatient and outpatient case numbers, country affiliation and university level in order to identify possible differences. On the basis of current guidelines for the five most relevant causes of “acute abdominal pain” (appendicitis, acute biliary tract disease, acute gastrointestinal bleeding, ileus and diverticulitis) an “evidence-based” laboratory profile was created and compared with the laboratory profiles of the hospitals.
The statistical analysis showed that the laboratory profiles of the clinics differed considerably from one another. German hospitals used significantly more laboratory parameters for “acute abdominal pain” than Swiss hospitals. However, there were no relevant differences in the number of laboratory test between university and non-university hospitals. A positive correlation was found between the number of beds as well as the number of inpatient cases and the number of laboratory parameters, indicating that larger hospitals tend to use a greater number of laboratory parameters. By contrast, there was no significant correlation between the number of outpatient cases and the amount of laboratory tests performed. Furthermore, an “evidence-based” laboratory profile for “acute abdominal pain” was developed from the recommendation of various guidelines, which includes 21 laboratory parameters. It was found that the participating hospitals followed the guideline recommendations to different degrees. Only two of the recommended parameters (bilirubin and ALAT) were included in all laboratory profiles, while about half of all suggested parameters were used in more than 50% of the hospitals. In addition to the guideline recommendations the hospitals utilised 23 further laboratory tests for “acute abdominal pain”. There were no significant differences in the fulfillment of the evidence-based laboratory profile between the countries or between university levels.
The results of this study show that there were quantitative and qualitative differences between the laboratory profiles of “acute abdominal pain” within the participating hospitals. Besides the parameters recommended in the guidelines, further laboratory tests for “acute abdominal pain” were used in the hospitals, some of which are no longer recommended or do not add any diagnostic value. It is therefore possible that the laboratory profiles utilised in the participating hospitals are not regularly reviewed and therefore do not correspond to the current scientific opinion. This could have an impact on the diagnosis and treatment of patients and could also be a source of additional unnecessary costs.
In Germany and Switzerland there is currently no consensus on which laboratory parameters should be included in a laboratory profile for “acute abdominal pain”. As part of this work, an “evidence-based” laboratory profile for “acute abdominal pain” was developed based on the evaluation of relevant guidelines. Compared to the laboratory profiles of the participating hospitals, significant deviations were found in some cases.
It is clear that although the symptom complex “acute abdominal pain” is one of the most important in emergency medicine, it has not yet been sufficiently researched in the context of laboratory diagnostics. In view of the clinical relevance and complexity of “acute abdominal pain”, efficient and economically reasonable laboratory diagnostics are of crucial importance for optimal medical care. This would not only increase diagnostic precision, but also sustainably improve the economic efficiency and quality of patient treatment. The “evidence-based” laboratory profile developed in this work could serve as a basis for further research evaluating the practicality and efficacy of such laboratory standards in clinical practice.
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Dates
Issued: 2026-01-20
Faculty
FB20:Medizin
Language
de
Data types
DoctoralThesis
Keywords
LaborprofileAkuter BauchschmerzLabormedizinNotaufnahme
DFG-subjects
2.22-10 - Toxikologie, Laboratoriumsmedizin
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Bauer, Isabell Nadine: Laborprofile in der Notaufnahme. : 2026-01-20.
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This item has been published with the following license: In Copyright