A dangerously underrated entity? Nonspecific complaints at emergency department presentation are associated with utilisation of less diagnostic resources
Dublin Core
Title
A dangerously underrated entity? Nonspecific complaints at emergency department presentation are associated with utilisation of less diagnostic resources
Subject
Non-specific complaints, Resource utilisation, Emergency department, Adult
Description
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.
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.
Creator
Tanja Birrenbach, Andrea Geissbühler, Aristomenis K. Exadaktylos, Wolf E. Hautz, Thomas C. Sauter and Martin Müller
Publisher
BMC Emergency Medicine
Date
(2021) 21:133
Contributor
Fajar bagus W
Format
PDF
Language
Indonesia
Type
Text
Files
Collection
Citation
Tanja Birrenbach, Andrea Geissbühler, Aristomenis K. Exadaktylos, Wolf E. Hautz, Thomas C. Sauter and Martin Müller, “A dangerously underrated entity? Nonspecific complaints at emergency department presentation are associated with utilisation of less diagnostic resources,” Repository Horizon University Indonesia, accessed November 14, 2024, https://repository.horizon.ac.id/items/show/3881.