Non-specific complaints at emergency department presentation result in unclear diagnoses and lengthened hospitalization: a prospective observational study
Abstract 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-sp...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2018-07-01
|
| Series: | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13049-018-0526-x |
| _version_ | 1818914428549070848 |
|---|---|
| author | Thomas C. Sauter Giuliana Capaldo Michele Hoffmann Tanja Birrenbach Stefanie C. Hautz Juliana E. Kämmer Aristomenis K. Exadaktylos Wolf E. Hautz |
| author_facet | Thomas C. Sauter Giuliana Capaldo Michele Hoffmann Tanja Birrenbach Stefanie C. Hautz Juliana E. Kämmer Aristomenis K. Exadaktylos Wolf E. Hautz |
| author_sort | Thomas C. Sauter |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-19T23:46:14Z |
| format | Article |
| id | doaj.art-077e16c516484a3e8bea80a5e212bde6 |
| institution | Directory Open Access Journal |
| issn | 1757-7241 |
| language | English |
| last_indexed | 2024-12-19T23:46:14Z |
| publishDate | 2018-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
| spelling | doaj.art-077e16c516484a3e8bea80a5e212bde62022-12-21T20:01:17ZengBMCScandinavian Journal of Trauma, Resuscitation and Emergency Medicine1757-72412018-07-012611710.1186/s13049-018-0526-xNon-specific complaints at emergency department presentation result in unclear diagnoses and lengthened hospitalization: a prospective observational studyThomas C. Sauter0Giuliana Capaldo1Michele Hoffmann2Tanja Birrenbach3Stefanie C. Hautz4Juliana E. Kämmer5Aristomenis K. Exadaktylos6Wolf E. Hautz7Department of Emergency Medicine, Inselspital, Bern University Hospital, University of BernDepartment of Emergency Medicine, Inselspital, Bern University Hospital, University of BernDepartment of Emergency Medicine, Inselspital, Bern University Hospital, University of BernDepartment of General Internal Medicine, Inselspital, Bern University Hospital, University of BernDepartment of Emergency Medicine, Inselspital, Bern University Hospital, University of BernCenter for Adaptive Rationality, Max Planck Institute for Human DevelopmentDepartment of Emergency Medicine, Inselspital, Bern University Hospital, University of BernDepartment of Emergency Medicine, Inselspital, Bern University Hospital, University of BernAbstract 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.http://link.springer.com/article/10.1186/s13049-018-0526-xNon-specific complaintsEmergency departmentLength of stay |
| spellingShingle | Thomas C. Sauter Giuliana Capaldo Michele Hoffmann Tanja Birrenbach Stefanie C. Hautz Juliana E. Kämmer Aristomenis K. Exadaktylos Wolf E. Hautz 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 Non-specific complaints Emergency department Length of stay |
| title | Non-specific complaints at emergency department presentation result in unclear diagnoses and lengthened hospitalization: a prospective observational study |
| title_full | Non-specific complaints at emergency department presentation result in unclear diagnoses and lengthened hospitalization: a prospective observational study |
| title_fullStr | Non-specific complaints at emergency department presentation result in unclear diagnoses and lengthened hospitalization: a prospective observational study |
| title_full_unstemmed | Non-specific complaints at emergency department presentation result in unclear diagnoses and lengthened hospitalization: a prospective observational study |
| title_short | Non-specific complaints at emergency department presentation result in unclear diagnoses and lengthened hospitalization: a prospective observational study |
| title_sort | non specific complaints at emergency department presentation result in unclear diagnoses and lengthened hospitalization a prospective observational study |
| topic | Non-specific complaints Emergency department Length of stay |
| url | http://link.springer.com/article/10.1186/s13049-018-0526-x |
| work_keys_str_mv | AT thomascsauter nonspecificcomplaintsatemergencydepartmentpresentationresultinuncleardiagnosesandlengthenedhospitalizationaprospectiveobservationalstudy AT giulianacapaldo nonspecificcomplaintsatemergencydepartmentpresentationresultinuncleardiagnosesandlengthenedhospitalizationaprospectiveobservationalstudy AT michelehoffmann nonspecificcomplaintsatemergencydepartmentpresentationresultinuncleardiagnosesandlengthenedhospitalizationaprospectiveobservationalstudy AT tanjabirrenbach nonspecificcomplaintsatemergencydepartmentpresentationresultinuncleardiagnosesandlengthenedhospitalizationaprospectiveobservationalstudy AT stefaniechautz nonspecificcomplaintsatemergencydepartmentpresentationresultinuncleardiagnosesandlengthenedhospitalizationaprospectiveobservationalstudy AT julianaekammer nonspecificcomplaintsatemergencydepartmentpresentationresultinuncleardiagnosesandlengthenedhospitalizationaprospectiveobservationalstudy AT aristomeniskexadaktylos nonspecificcomplaintsatemergencydepartmentpresentationresultinuncleardiagnosesandlengthenedhospitalizationaprospectiveobservationalstudy AT wolfehautz nonspecificcomplaintsatemergencydepartmentpresentationresultinuncleardiagnosesandlengthenedhospitalizationaprospectiveobservationalstudy |