Chief complaints in medical emergencies: do they relate to underlying disease and outcome? The Charité Emergency Medicine Study (CHARITEM)

Mockel, Martin, Searle, Julia, Muller, Reinhold, Slagman, Anna, Storchmann, Harald, Oestereich, Philipp, Wyrwich, Werner, Ale-Abaei, Angela, Vollert, Joern O., Koch, Matthias, and Somasundaram, Rajan (2013) Chief complaints in medical emergencies: do they relate to underlying disease and outcome? The Charité Emergency Medicine Study (CHARITEM). European Journal of Emergency Medicine, 20 (2). pp. 103-108.

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Abstract

Objectives: To evaluate the relationship between chief complaints and their underlying diseases and outcome in medical emergency departments (EDs).

Methods: All 34 333 patients who attended two of the EDs of the Charite Berlin over a 1-year period were included in the analysis. Data were retrieved from the hospital information system. For study purposes, the chief complaint (chest pain, dyspnoea, abdominal pain, headache or 'none of these symptoms') was prospectively documented in an electronic file by the ED-physician. Documentation was mandatory.

Results: The majority of patients (66%) presented with 'none of these symptoms', 11.5% with chest pain, 11.1% with abdominal pain and 7.4% with dyspnoea. In total, 39.4% of all patients were admitted to the hospital. The leading diagnosis was acute coronary syndrome (50.7%) for chest pain in-patients and chronic obstructive pulmonary disease (16.5%) and heart failure (16.1%) for in-patients with dyspnoea. The causes of abdominal pain in in-patients were of diverse gastrointestinal origin (47.2%). In-hospital mortality of in-patients was 4.7%. Patients with chest pain had significantly lower in-hospital mortality (0.9%) than patients with dyspnoea (9.4%) and abdominal pain (5.1%).

Conclusion: The majority of emergency patients lack diagnosis-specific symptoms. Chief complaints help preselect patients but must not be mistaken as disease specific. Mortality largely differs depending on the chief complaint. In chest pain patients, standardized processes may be one factor that explains the low mortality in this group.

Item ID: 26348
Item Type: Article (Research - C1)
ISSN: 1473-5695
Keywords: diagnosis, emergency medicine, outcome assessment, symptoms
Date Deposited: 19 Jul 2013 06:35
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111799 Public Health and Health Services not elsewhere classified @ 100%
SEO Codes: 92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920499 Public Health (excl. Specific Population Health) not elsewhere classified @ 100%
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