Evaluating the Diagnostic Value of Clinical and Laboratory Parameters in Older Adults with Abdominal Pain: A Retrospective Analysis of CT Predictors

Background and Objectives: This study aims to evaluate easily accessible clinical and laboratory parameters in older adults presenting with nontraumatic abdominal pain and to explore factors associated with significant findings on abdominal computed tomography (CT). The goal is to help prevent diagnostic delays and reduce emergency department (ED) length of stay by minimizing unnecessary testing. Materials and Methods: This retrospective cohort study evaluated patients aged 65 years and older presenting to a high-volume tertiary ED with acute nontraumatic abdominal pain who underwent abdominal CT between January 2020 and January 2022. To maintain data integrity in a crowded ED environment, only patients with complete medical documentation were enrolled. Based on objective radiological outcomes from official reports, patients were categorized into two groups: those with Acute Pathological CT Findings (acute intra-abdominal pathology explaining the presentation) and those with Non-Acute/Negative CT Findings (normal scans, chronic, incidental, or extra-abdominal findings). Multivariable logistic regression was performed to identify independent predictors of acute pathological findings. Results: A total of 503 patients were included, of whom 178 (35.3%) had Acute Pathological CT Findings. Univariable analyses showed that elevated Alanine Aminotransferase (ALT), total bilirubin, and Gamma-Glutamyl Transferase (GGT) were significantly associated with acute pathological findings, whereas higher levels of Blood Urea Nitrogen (BUN), creatinine, and troponin were more prevalent in the Non-Acute/Negative CT Findings group. Conclusions: Despite the identified associations, a reliable predictive model could not be established; therefore, CT is considered to remain a fundamental tool for accurate diagnosis in older adults.