Systematically assessed symptoms as outcome predictors in emergency patients

Bingisser, Roland; Dietrich, Maximilian; Ortega, Ricardo Nieves; Malinovska, Alexandra; Bosia, Tito; Nickel, Christian H.

doi:10.1016/j.ejim.2017.09.013

Cited by 44 publications

(66 citation statements)

References 19 publications

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“…In comparison, the incidence of AP was comparable to that found in European [4] and US studies [36,37]. However, in our prospective all-comer cohort, AP was only the seventh most prevalent symptom, while it was the second most prevalent in the CHARITEM study and often among the top five symptoms in European studies [5]. As we systematically interviewed all patients about the presence of abdominal pain, underreporting is highly unlikely.…”

Section: Discussionsupporting

confidence: 79%

“…While survival was excellent in patients under 65 years of age, it was lower in patients 65 and older. Abdominal pain as a group does not seem to be a high-risk symptom, unlike dyspnea, altered mentation, and nonspecific complaints, such as generalized weakness [5].…”

Section: Discussionmentioning

confidence: 94%

“…Abdominal pain (AP) is among the most common reasons to present to an emergency department (ED) [1][2][3]. In the US and in Europe, it is consistently one of the top chief complaints [4,5]. Differential diagnosis ranges between self-limiting nonspecific abdominal pain [6,7] and life-threatening conditions [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

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Acute Abdominal Pain: Missed Diagnoses, Extra-Abdominal Conditions, and Outcomes

Osterwalder

Özkan

Malinovska

et al. 2020

JCM

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Abdominal pain (AP) is a common reason for presentation to an emergency department (ED). With this prospective, observational all-comer study, we aimed to answer three questions: Which diagnoses are most often missed? What is the incidence of extra-abdominal causes? What is the prognosis of abdominal pain in a tertiary urban European ED? Participants were systematically interviewed for the presence of 35 predefined symptoms. For all patients with abdominal pain, the index visit diagnoses were recorded. Related representation was defined as any representation, investigation, or surgery related to the index visit (open time frame). If a diagnosis changed between index visit and representation, it was classified as missed diagnosis. Among 3960 screened presentations, 480 (12.1%) were due to AP. Among 63 (13.1%) related representations, the most prevalent causes were cholelithiasis, gastroenteritis, and urinary retention. A missed diagnosis was attributed to 27 (5.6%) presentations. Extra-abdominal causes were identified in 162 (43%) presentations. Thirty-day mortality was comparable to that of all other ED patients (2.2% vs. 2.1%). Patients with abdominal pain had a low risk of representation, and the majority of representations due to missed diagnoses were of benign origin. The high incidence of extra-abdominal causes is noteworthy, as this may induce change to differential diagnosis of abdominal pain.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 94%

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Acute Abdominal Pain: Missed Diagnoses, Extra-Abdominal Conditions, and Outcomes

Osterwalder

Özkan

Malinovska

et al. 2020

JCM

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“…Our study provided evidence for both hypotheses: On one hand, two thirds of these patients were admitted to the hospital, and half of these patients were hospitalized 5 days or longer. On the other hand, in‐hospital mortality was 2%, and direct transfer to intensive care occurred in just 4% of these patients, which is comparable to an average ED population . Our data show differences in hospital and ED LOS between the centers.…”

Section: Discussionmentioning

confidence: 99%

Older Patients with Low‐Energy Falls Presenting to the Emergency Department: Characteristics and Outcomes

Pedersen

Lampart

Kammerlander

et al. 2019

J American Geriatrics Society

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“…Patients' ED diagnoses is a well-accepted predictor of short term mortality. The patients primary ED diagnoses and the patients ED chief complaint as well as the combination of chief complaint have been closely associated to patient outcome such as hospitalization and mortality [50][51][52][53]. The accuracy of comorbidity scores can be questioned and data suggest that comorbidity scores only provide a modest improvement on age adjustment [54].…”

Section: Strengths and Limitationsmentioning

confidence: 99%

The association between length of stay in the emergency department and short term mortality

Wessman

Ärnlöv

Carlsson

et al. 2020

Preprint

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Background: The detrimental effects of increased length of stay at the emergency department (ED-LOS) for patient outcome have been sparsely studied in the Swedish setting. Our aim was to further explore the association between ED-LOS and short term mortality in patients admitted to the EDs of two large University hospitals in Sweden. Methods: All adult patients (> 18 years) visiting the ED at the Karolinska University Hospital, Sweden, from 1/1/2010 to 1/1/2015 (n=639 385) were retrospectively included. Logistic regression analysis was used to determine association between ED-LOS and 7 and 30-day mortality rates. All patients were triaged according to the RETTS-A into different levels of medical urgency and subsequently separated into five quintiles of ED-LOS. Results: We observed that prolonged ED-LOS was associated with increased mortality for patients with lowest triage priority (risk estimates for 30-day mortality were OR 1.49 (CI 95% 1.20-1.85) for patients with triage priority group 4 and the highest quintile of ED-LOS. No such association was observed in patients with the highest triage priority group and in patients admitted to in-hospital care. Conclusion : Our data suggest that increased ED-LOS could be associated with slightly increased short term mortality in patients with lower clinical urgency and dismissed from the ED but that this does not include patients admitted to in-hospital care.

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Systematically assessed symptoms as outcome predictors in emergency patients

Cited by 44 publications

References 19 publications

Acute Abdominal Pain: Missed Diagnoses, Extra-Abdominal Conditions, and Outcomes

Acute Abdominal Pain: Missed Diagnoses, Extra-Abdominal Conditions, and Outcomes

Older Patients with Low‐Energy Falls Presenting to the Emergency Department: Characteristics and Outcomes

The association between length of stay in the emergency department and short term mortality

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