Abstract
BackgroundUp 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.MethodsAll 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.ResultsSeven 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]).ConclusionsNon-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.
Highlights
Up to 20% of patients admitted to an emergency department present with non-specific complaints
Most studies on the issue, demonstrate that non-specific chief complaints (NSC) are much more prevalent in elderly patients [8, 11, 12] which makes it difficult to tell whether the unfavorable outcomes of patients presenting with NSC to an emergency department (ED) truly result from their challenging non-specific chief complaint or are a consequence of the patients’ older age
For metric variables, we tested for normality using Shapiro Wilks test. Because all these variables were non-normally distributed, we describe them using Median and interquartile range (IQR)
Summary
Up to 20% of patients admitted to any emergency department (ED) present with non-specific chief complaints (NSC), such as generalized weakness, gait disturbance or tiredness [1]. Most studies on the issue, demonstrate that NSC are much more prevalent in elderly patients [8, 11, 12] which makes it difficult to tell whether the unfavorable outcomes of patients presenting with NSC to an ED truly result from their challenging non-specific chief complaint or are a consequence of the patients’ older age. Because elderly patients represent the fastest growing emergency department population [8, 12], NSC are of increasing importance to emergency care
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 callMore From: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Disclaimer: 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.
