A dangerously underrated entity? Non-specific complaints at emergency department presentation are associated with utilisation of less diagnostic resources

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...

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Autores principales:	Tanja Birrenbach, Andrea Geissbühler, Aristomenis K. Exadaktylos, Wolf E. Hautz, Thomas C. Sauter, Martin Müller
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Non-specific complaints Resource utilisation Emergency department Adult Special situations and conditions RC952-1245 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
Acceso en línea:	https://doaj.org/article/2c57ce848e1342dab42ce357de98e897
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spelling	oai:doaj.org-article:2c57ce848e1342dab42ce357de98e8972021-11-14T12:15:58ZA dangerously underrated entity? Non-specific complaints at emergency department presentation are associated with utilisation of less diagnostic resources10.1186/s12873-021-00531-21471-227Xhttps://doaj.org/article/2c57ce848e1342dab42ce357de98e8972021-11-01T00:00:00Zhttps://doi.org/10.1186/s12873-021-00531-2https://doaj.org/toc/1471-227XAbstract 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.Tanja BirrenbachAndrea GeissbühlerAristomenis K. ExadaktylosWolf E. HautzThomas C. SauterMartin MüllerBMCarticleNon-specific complaintsResource utilisationEmergency departmentAdultSpecial situations and conditionsRC952-1245Medical emergencies. Critical care. Intensive care. First aidRC86-88.9ENBMC Emergency Medicine, Vol 21, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Non-specific complaints Resource utilisation Emergency department Adult Special situations and conditions RC952-1245 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
spellingShingle	Non-specific complaints Resource utilisation Emergency department Adult Special situations and conditions RC952-1245 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Tanja Birrenbach Andrea Geissbühler Aristomenis K. Exadaktylos Wolf E. Hautz Thomas C. Sauter Martin Müller A dangerously underrated entity? Non-specific complaints at emergency department presentation are associated with utilisation of less diagnostic resources
description	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.
format	article
author	Tanja Birrenbach Andrea Geissbühler Aristomenis K. Exadaktylos Wolf E. Hautz Thomas C. Sauter Martin Müller
author_facet	Tanja Birrenbach Andrea Geissbühler Aristomenis K. Exadaktylos Wolf E. Hautz Thomas C. Sauter Martin Müller
author_sort	Tanja Birrenbach
title	A dangerously underrated entity? Non-specific complaints at emergency department presentation are associated with utilisation of less diagnostic resources
title_short	A dangerously underrated entity? Non-specific complaints at emergency department presentation are associated with utilisation of less diagnostic resources
title_full	A dangerously underrated entity? Non-specific complaints at emergency department presentation are associated with utilisation of less diagnostic resources
title_fullStr	A dangerously underrated entity? Non-specific complaints at emergency department presentation are associated with utilisation of less diagnostic resources
title_full_unstemmed	A dangerously underrated entity? Non-specific complaints at emergency department presentation are associated with utilisation of less diagnostic resources
title_sort	dangerously underrated entity? non-specific complaints at emergency department presentation are associated with utilisation of less diagnostic resources
publisher	BMC
publishDate	2021
url	https://doaj.org/article/2c57ce848e1342dab42ce357de98e897
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A dangerously underrated entity? Non-specific complaints at emergency department presentation are associated with utilisation of less diagnostic resources

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