A dangerously underrated entity? Non-specific complaints at emergency department presentation are associated with utilisation of less diagnostic resources

Birrenbach, Tanja; Geissbühler, Andrea; Exadaktylos, Aristomenis K.; Hautz, Wolf E.; Sauter, Thomas C.; Müller, Martin (2021). A dangerously underrated entity? Non-specific complaints at emergency department presentation are associated with utilisation of less diagnostic resources. BMC emergency medicine, 21(1), p. 133. BioMed Central 10.1186/s12873-021-00531-2

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Background: Patients presenting with non-specific complaints (NSC), such as generalised weakness, or feeling unwell, constitute about 20% of emergency care consultations. In contrast to patients presenting with specific symptoms, these patients experience more hospitalisations, longer stays in hospital and even higher mortality. However, little is known about the actual resources spent on patients with NSC in the emergency department (ED).

Methods: We have conducted a retrospective analysis from January 1st, 2013 until December 31st, 2017 in a Swiss tertiary care ED to assess the impact of NSC on the utilisation of diagnostic resources in adult patients with highlyurgent or urgent medical complaints.

Results: We randomly selected 1500 medical consultations from our electronic health record database: The majority of patients (n = 1310, 87.3%) presented with a specific complaint; n = 190 (12.7%) with a NSC. Univariate analysis showed no significant difference in the utilisation of total diagnostic resources in the ED [specific complaints: 844 (577-1313) vs. NSC: 778 (551-1183) tax points, p = 0.092, median (interquartile range)]. A backward selection logistic regression model was adjusted for the identified covariates (age, diabetes, cerebrovascular and liver disease, malignancy, past myocardial infarction, antihypertensive, antithrombotic or antidiabetic medication, night or weekend admission and triage category). This identified a significant association of NSC with lower utilisation of ED diagnostic resources [geometric mean ratio (GMR) 0.91, 95% CI: 0.84-0.99, p = 0.042].

Conclusions: Non-specific complaints (NSC) are a frequent reason for emergency medicine consultations and are associated with lower utilisation of diagnostic resources during ED diagnostic testing than with specific complaints.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > University Emergency Center

UniBE Contributor:

Birrenbach, Tanja Nicole; Exadaktylos, Aristomenis; Hautz, Wolf; Sauter, Thomas Christian and Müller, Martin

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1471-227X

Publisher:

BioMed Central

Language:

English

Submitter:

Romana Saredi

Date Deposited:

07 Dec 2021 19:16

Last Modified:

12 Dec 2021 02:17

Publisher DOI:

10.1186/s12873-021-00531-2

PubMed ID:

34758749

BORIS DOI:

10.48350/161919

URI:

https://boris.unibe.ch/id/eprint/161919

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