Non-specific complaints at emergency department presentation result in unclear diagnoses and lengthened hospitalization: a prospective observational study.

Sauter, Thomas; Capaldo, Giuliana; Hoffmann, Michèle; Birrenbach, Tanja Nicole; Hautz, Stefanie C.; Kämmer, Juliana E; Exadaktylos, Aristomenis; Hautz, Wolf (2018). Non-specific complaints at emergency department presentation result in unclear diagnoses and lengthened hospitalization: a prospective observational study. Scandinavian journal of trauma, resuscitation and emergency medicine, 26(1), p. 60. BioMed Central 10.1186/s13049-018-0526-x

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BACKGROUND Up to 20% of patients admitted to an emergency department present with non-specific complaints. Retrospective studies suggest an increased risk of misdiagnosis and hospital admission for these patients, but prospective comparisons of the outcomes of emergency patients with non-specific complaints versus specific complaints are lacking. METHODS All consecutive patients ≥18 years of age admitted to any internal medicine ward at Bern University Hospital via the emergency department from August 15th 2015 to December 7th 2015 were prospectively included and followed up upon. Patients with non-specific complaints were compared against those with specific complaints regarding the quality of their emergency department diagnosis, length of hospital stay and in-hospital mortality. RESULTS Seven hundred and-eleven patients, 165 (23.21%) with non-specific complaints and 546 with specific complaints, were included in this study. No differences between patient groups regarding age, gender or initial severity of the medical problem (deducted from triage category and treatment in a resuscitation bay) were found. Patients with non-specific complaints received more unspecific diagnoses (30.3% vs. 23.1%, p = 0.001, OR = 1.82 [95% CI 1.159-2.899]), were hospitalized significantly longer (Median = 6.51 (IQR = 5.85) vs. 5.22 (5.83) days, p = 0.025, d = 0.2) but did not have a higher mortality than patients with specific complaints (7.3% vs. 3.7%, p = 0.087, OR 1.922 [95% CI 0.909-4.065]). CONCLUSIONS Non-specific complaints in patients admitted to an emergency department result in low-quality diagnoses and lengthened hospitalization, despite the patients being comparable to patients with specific complaints at admission.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > University Emergency Center
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine

UniBE Contributor:

Sauter, Thomas; Capaldo, Giuliana; Hoffmann, Michèle; Birrenbach, Tanja Nicole; Exadaktylos, Aristomenis and Hautz, Wolf

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1757-7241

Publisher:

BioMed Central

Language:

English

Submitter:

Christine Baumgartner

Date Deposited:

15 Feb 2019 16:58

Last Modified:

17 Feb 2019 02:41

Publisher DOI:

10.1186/s13049-018-0526-x

PubMed ID:

30012186

Uncontrolled Keywords:

Emergency department Length of stay Non-specific complaints

BORIS DOI:

10.7892/boris.123195

URI:

https://boris.unibe.ch/id/eprint/123195

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