Highlights
- •Non-specific presentations represent 17.4% of presentations.
- •No difference was seen in mortality between specific and non-specific presentations.
- •No difference was seen in length of stay for specific and non-specific presentations.
Abstract
Aim
To investigate whether a specific (SP) or non-specific (NSP) clinical presentation,
predicts prognosis and in-hospital resource utilization in emergency medical admissions.
Methods
We studied admissions over 5 years (2015–2019) and classified the symptom presentation
as SP or NSP. The predictive capacity of the NSP category was related to 30-day in-hospital
mortality with a multivariable logistic regression model. Utilization of procedures/services
was related to hospital length of stay (LOS) with zero truncated Poisson regression.
Results
There were 39,776 admissions in 23,995 patients. A NSP occurred in 18.2% of our top
20 clinical presentations; the top five being shortness of breath (12.8%), ‘unwell’
(7.1%), collapse (4.1%), abdominal pain (3.6%) and headache (2.7%). Baseline demographic
characteristics were similar and unrelated to type of presentation; the model adjusted
mortality by SP 4.0% (95% CI: 3.8%, 4.2%) or NSP 3.9% (95% CI: 3.5%, 4.4%) was identical.
LOS was a dependant quantitative function of procedures/services undertaken; for the
top two presentations of shortness of breath (SP) or unwell (NSP) there was no relationship
between a SP or NSP presentation and hospital utilization of procedures/services or
LOS.
Conclusion
Our data suggest no utility for a categorisation of presentations as specific or non-specific
in terms of provision of prognostic information nor as an indicator of the pattern
of hospital investigation or LOS.
Keywords
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Article info
Publication history
Published online: February 16, 2021
Accepted:
February 6,
2021
Received in revised form:
January 25,
2021
Received:
December 10,
2020
Identification
Copyright
© 2021 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
