Discrepancy between admission diagnosis in emergency and final diagnosis in ward and its correlation with length of hospital stay and mortality

Background: Inception of emergency medicine as a specialty in India is on a rise. Data on the accuracy of diagnosis made in emergency rooms in India is scarce and with varied results with especially no such data available from our part of the country. Aim: The aim of this study was to evaluate the d...

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Main Authors: Umer Un Nabi, Asma Rafi, Muzaffar Maqbool, Parvaiz Ahmad Shah
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2022-01-01
Series:Current Medicine Research and Practice
Subjects:
Online Access:http://www.cmrpjournal.org/article.asp?issn=2352-0817;year=2022;volume=12;issue=5;spage=199;epage=204;aulast=Nabi
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author Umer Un Nabi
Asma Rafi
Muzaffar Maqbool
Parvaiz Ahmad Shah
author_facet Umer Un Nabi
Asma Rafi
Muzaffar Maqbool
Parvaiz Ahmad Shah
author_sort Umer Un Nabi
collection DOAJ
description Background: Inception of emergency medicine as a specialty in India is on a rise. Data on the accuracy of diagnosis made in emergency rooms in India is scarce and with varied results with especially no such data available from our part of the country. Aim: The aim of this study was to evaluate the discrepancy between admission diagnosis in emergency and final diagnosis in ward and its correlation with length of hospital stay and outcome. This study was an observational prospective study. Materials and Methods: Patients were categorised as per the International Classification of Diseases – Version 10. A total of 2000 patients were enrolled in the study. The patients were followed from admission to discharge. Data were categorised into two major groups – 'Concordant' diagnosis and 'Discordant' diagnosis. Univariate analysis was performed using SPSS version 20.0. Results: Five hundred and fifty-three (27.65%) patients had a final diagnosis in ward discordant from the initial diagnosis in the medical emergency room. The frequency of discrepancy was highest for the genitourinary system (39%) and relatively low for neoplasm (16%). The average length of hospital stay in the concordant group of patients was 5.15 days, whereas it was 7.05 days in the discordant group (P = 0.003). There was a statistically significant increase in percentage mortality in patients when initial and final diagnoses did not match (P = 0.0005). Conclusions: A diagnostic discrepancy of 27.65% occurred between admission diagnosis in the medical emergency room and final diagnosis in ward. The diagnostic discrepancy resulted in a significant increase in the length of hospital stay and mortality.
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spelling doaj.art-0c9d2072ed52405cae02aeb9243b13d72022-12-22T04:14:05ZengWolters Kluwer Medknow PublicationsCurrent Medicine Research and Practice2352-08172352-08252022-01-0112519920410.4103/cmrp.cmrp_41_22Discrepancy between admission diagnosis in emergency and final diagnosis in ward and its correlation with length of hospital stay and mortalityUmer Un NabiAsma RafiMuzaffar MaqboolParvaiz Ahmad ShahBackground: Inception of emergency medicine as a specialty in India is on a rise. Data on the accuracy of diagnosis made in emergency rooms in India is scarce and with varied results with especially no such data available from our part of the country. Aim: The aim of this study was to evaluate the discrepancy between admission diagnosis in emergency and final diagnosis in ward and its correlation with length of hospital stay and outcome. This study was an observational prospective study. Materials and Methods: Patients were categorised as per the International Classification of Diseases – Version 10. A total of 2000 patients were enrolled in the study. The patients were followed from admission to discharge. Data were categorised into two major groups – 'Concordant' diagnosis and 'Discordant' diagnosis. Univariate analysis was performed using SPSS version 20.0. Results: Five hundred and fifty-three (27.65%) patients had a final diagnosis in ward discordant from the initial diagnosis in the medical emergency room. The frequency of discrepancy was highest for the genitourinary system (39%) and relatively low for neoplasm (16%). The average length of hospital stay in the concordant group of patients was 5.15 days, whereas it was 7.05 days in the discordant group (P = 0.003). There was a statistically significant increase in percentage mortality in patients when initial and final diagnoses did not match (P = 0.0005). Conclusions: A diagnostic discrepancy of 27.65% occurred between admission diagnosis in the medical emergency room and final diagnosis in ward. The diagnostic discrepancy resulted in a significant increase in the length of hospital stay and mortality.http://www.cmrpjournal.org/article.asp?issn=2352-0817;year=2022;volume=12;issue=5;spage=199;epage=204;aulast=Nabiconcordant diagnosisdiagnostic discrepancydiscordant diagnosislength of hospital staymortality
spellingShingle Umer Un Nabi
Asma Rafi
Muzaffar Maqbool
Parvaiz Ahmad Shah
Discrepancy between admission diagnosis in emergency and final diagnosis in ward and its correlation with length of hospital stay and mortality
Current Medicine Research and Practice
concordant diagnosis
diagnostic discrepancy
discordant diagnosis
length of hospital stay
mortality
title Discrepancy between admission diagnosis in emergency and final diagnosis in ward and its correlation with length of hospital stay and mortality
title_full Discrepancy between admission diagnosis in emergency and final diagnosis in ward and its correlation with length of hospital stay and mortality
title_fullStr Discrepancy between admission diagnosis in emergency and final diagnosis in ward and its correlation with length of hospital stay and mortality
title_full_unstemmed Discrepancy between admission diagnosis in emergency and final diagnosis in ward and its correlation with length of hospital stay and mortality
title_short Discrepancy between admission diagnosis in emergency and final diagnosis in ward and its correlation with length of hospital stay and mortality
title_sort discrepancy between admission diagnosis in emergency and final diagnosis in ward and its correlation with length of hospital stay and mortality
topic concordant diagnosis
diagnostic discrepancy
discordant diagnosis
length of hospital stay
mortality
url http://www.cmrpjournal.org/article.asp?issn=2352-0817;year=2022;volume=12;issue=5;spage=199;epage=204;aulast=Nabi
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AT parvaizahmadshah discrepancybetweenadmissiondiagnosisinemergencyandfinaldiagnosisinwardanditscorrelationwithlengthofhospitalstayandmortality