Universität zu Köln

Birrenbach, Tanja, Geissbuehler, Andrea, Exadaktylos, Aristomenis K., Hautz, Wolf E., Sauter, Thomas C. and Mueller, Martin (2021). A dangerously underrated entity? Non-specific complaints at emergency department presentation are associated with utilisation of less diagnostic resources. BMC Emerg. Med., 21 (1). LONDON: BMC. ISSN 1471-227X

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Abstract

Background Patients 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). Methods We 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. Results We 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]. Conclusions Non-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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Birrenbach, Tanja UNSPECIFIED UNSPECIFIED UNSPECIFIED Geissbuehler, Andrea UNSPECIFIED UNSPECIFIED UNSPECIFIED Exadaktylos, Aristomenis K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hautz, Wolf E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sauter, Thomas C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-575884
DOI:	10.1186/s12873-021-00531-2
Journal or Publication Title:	BMC Emerg. Med.
Volume:	21
Number:	1
Date:	2021
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	1471-227X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MORTALITY; MEDICINE; OUTCOMES Multiple languages Emergency Medicine Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/57588