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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 1/2018

Open Access 01-12-2018 | Original research

Non-specific complaints at emergency department presentation result in unclear diagnoses and lengthened hospitalization: a prospective observational study

Authors: Thomas C. Sauter, Giuliana Capaldo, Michele Hoffmann, Tanja Birrenbach, Stefanie C. Hautz, Juliana E. Kämmer, Aristomenis K. Exadaktylos, Wolf E. Hautz

Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Issue 1/2018

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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.
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Metadata
Title
Non-specific complaints at emergency department presentation result in unclear diagnoses and lengthened hospitalization: a prospective observational study
Authors
Thomas C. Sauter
Giuliana Capaldo
Michele Hoffmann
Tanja Birrenbach
Stefanie C. Hautz
Juliana E. Kämmer
Aristomenis K. Exadaktylos
Wolf E. Hautz
Publication date
01-12-2018
Publisher
BioMed Central
DOI
https://doi.org/10.1186/s13049-018-0526-x

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