Abstract
BackgroundPatients 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).MethodsWe 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.ResultsWe 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].ConclusionsNon-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.
Highlights
Patients presenting with non-specific complaints (NSC), such as generalised weakness, or feeling unwell, constitute about 20% of emergency care consultations
We recently demonstrated that mortality is higher in hospitalised patients presenting with Non-specific complaints (NSC) to our emergency department (ED) [11] than for patients with specific complaints; this is consistent with reports from other countries [1, 3, 6, 7, 12,13,14]
As the number of ED consultations and overall health costs are both increasing and in view of the growing awareness of the important but largely unknown entity of patients with NSC, we have investigated the impact of NSC on the utilisation of diagnostic resources in the ED; to our knowledge, this has never been comprehensively studied
Summary
Patients presenting with non-specific complaints (NSC), such as generalised weakness, or feeling unwell, constitute about 20% of emergency care consultations. Non-specific complaints (NSC), such as generalised weakness and fatigue or feeling unwell, make up a large group of complaints in emergency care [1,2,3] These “common unknown unknowns” [4] encompass a large number of possible, even life-threatening diagnoses [1, 5,6,7,8,9]. We recently demonstrated that mortality is higher in hospitalised patients presenting with NSC to our emergency department (ED) [11] than for patients with specific complaints; this is consistent with reports from other countries [1, 3, 6, 7, 12,13,14]. This statement can be confirmed when looking at the entire ED population (all patients admitted and discharged) [7, 12, 14, 15]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
