Chief complaints, underlying diagnosis, and prognosis in patients admitted to emergency departments in Denmark: a population-based cohort study (COMPASS)

Michael Dan Arvig*, Isik Somuncu Johansen, Flemming S Rosenvinge, Christian Backer Mogensen, Helene Skjøt-Arkil, Annmarie Touborg Lassen

*Corresponding author af dette arbejde

Publikation: KonferencebidragAbstractForskningpeer review

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Abstract

Background
Patients are commonly admitted to an emergency department (ED) with one or more primary symptoms. The initial workup and subsequent monitoring are driven by both the symptoms and the underlying diagnosis and prognosis. Knowledge of the association between symptoms, diagnosis, and prognosis is therefore important to optimize treatment and improve patient outcomes.
The primary aim of this study was to describe the relationship between presenting symptoms and underlying diagnosis in patients admitted to EDs in a cohort of patients in the Region of Southern Denmark (RSD). The secondary aim was to examine the length of stay (LOS), transfers to the intensive care unit (ICU), readmissions, and mortality in relation to the chief complaints.

Material and Methods
We included acute hospital contacts 18 years or older referred to seven different hospitals in RSD from January 2016 to March 2018. At triage, patients have an acute package assigned identifying them according to their chief complaints. Outcome variables were diagnoses, mortality, readmission, ICU transfer, and LOS.

Results
In total, 242,862 acute contacts were included. Median age 63 years (IQR 43-76). 51.6% women. The most frequent symptoms for referral were: unspecific complaints (19.0%), abdominal pain (15.4%), dyspnea (11.1%), fever (7.8%), chest pain (7.2%), neurologic disorder (6.4%) others (16,6%). In 16.5% of the cases, information about the primary complaint was missing. Patients were often discharged with either a symptom-based- (23.7%) or an observational diagnosis (17.6%). Among the specific diagnoses’ pneumonia (3.9%), chronic obstructive lung disease (2.8%), atrial fibrillation-/flutter (2.5%), and alcohol abstinence (1.5%) were the most frequent. Dyspnea was associated with the highest 7-day mortality (4.4%), most transfers to the ICU (4.4%), and readmissions within 7 days (12.0%). Patients with fever had the longest LOS (4.7 days).

Conclusion
Patients are primarily admitted and discharge with unspecific complaints and an unspecific diagnose. Dyspneic patients presented the highest mortality, number of ICU transfers, and readmissions.
OriginalsprogEngelsk
StatusUdgivet - 14 okt. 2021
BegivenhedDanish Emergency Medicine Conference 9 (DEMC9) - Copenhagen, Copenhagen, Danmark
Varighed: 14 okt. 202115 okt. 2021
https://www.meetingplanners.dk/subsites/demc/index.html

Konference

KonferenceDanish Emergency Medicine Conference 9 (DEMC9)
Land/OmrådeDanmark
ByCopenhagen
Periode14/10/2115/10/21
Internetadresse

Emneord

  • Prognose
  • Symptomer
  • Ødelighed
  • Klager
  • diagnose
  • Akutmedicin

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