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Trajectories of survival in patients with nonspecific complaints

      Patients presenting to acute care settings with nonspecific complaints (NSCs) are at high risk of adverse outcomes [
      • Safwenberg U.
      • Terént A.
      • Lind L.
      The emergency department presenting complaint as predictor of in-hospital fatality.
      ,
      • Wachelder J.J.H.
      • et al.
      Elderly emergency patients presenting with non-specific complaints: characteristics and outcomes.
      ] and pose diagnostic and prognostic challenges [
      • Peng A.
      • et al.
      The proportion of correct diagnoses is low in emergency patients with nonspecific complaints presenting to the emergency department.
      ]. The majority of these patients suffers from acute and serious conditions [
      • Nemec M.
      • et al.
      Patients presenting to the emergency department with non-specific complaints: the Basel non-specific complaints (BANC) study.
      ]. Due to the prevalence of chronic disease [
      • Karakoumis J.
      • et al.
      Emergency presentations with nonspecific complaints-the burden of morbidity and the Spectrum of underlying disease: nonspecific complaints and underlying disease.
      ], nonorganic or functional problems [
      • Schaefert R.
      • et al.
      Non-specific, functional, and somatoform bodily complaints.
      ], therapy induced conditions [
      • Nickel C.H.
      • et al.
      Drug-related emergency department visits by elderly patients presenting with non-specific complaints.
      ], or acute complications in chronic conditions, several distinct trajectories of survival may be observed. Allocating NSCs patients into predefined groups may be used in clinical practice, if the framework can simply, but reliably, categorise NSCs with different trajectories. Recently, it was hypothesized that the prognosis of NSCs is likely related to whether or not they are transient, recurrent or persistent [
      • Kellett J.
      • Nickel C.H.
      What are nonspecific complaints and what are their causes and outcomes? The common unknown unknowns of medicine.
      ].

      Keywords

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