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Combinations of Symptoms in Emergency Presentations: Prevalence and Outcome

The predictive power of certain symptoms, such as dyspnoea, is well known. However, research is limited to the investigation of single chief complaints. This is in contrast to patients in the emergency department (ED) presenting usually more than one symptom. We aimed to identify the most common com...

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Autores principales: Kuster, Tobias, Nickel, Christian H., Jenny, Mirjam A., Blaschke, Lana L., Bingisser, Roland
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6462968/
https://www.ncbi.nlm.nih.gov/pubmed/30870989
http://dx.doi.org/10.3390/jcm8030345
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author Kuster, Tobias
Nickel, Christian H.
Jenny, Mirjam A.
Blaschke, Lana L.
Bingisser, Roland
author_facet Kuster, Tobias
Nickel, Christian H.
Jenny, Mirjam A.
Blaschke, Lana L.
Bingisser, Roland
author_sort Kuster, Tobias
collection PubMed
description The predictive power of certain symptoms, such as dyspnoea, is well known. However, research is limited to the investigation of single chief complaints. This is in contrast to patients in the emergency department (ED) presenting usually more than one symptom. We aimed to identify the most common combinations of symptoms and to report their related outcomes: hospitalisation, admission to intensive care units, and mortality. This is a secondary analysis of a consecutive sample of all patients presenting to the ED of the University Hospital Basel over a total time course of 6 weeks. The presence of 35 predefined symptoms was systematically assessed upon presentation. A total of 3960 emergency patients (median age 51, 51.7% male) were included. Over 130 combinations of two, 80 combinations of three, and 10 combinations of four symptoms occurred 42 times or more during a total inclusion period of 42 days. Two combinations of two symptoms were predictive for in-hospital mortality: weakness and fatigue (Odds ratio (OR) = 2.45), and weakness and headache (OR = 3.01). Combinations of symptoms were frequent. Nonspecific complaints (NSCs), such as weakness and fatigue, are among the most frequently reported combinations of symptoms, and are associated with adverse outcomes. Systematically assessing symptoms may add valuable information for prognosis and may therefore influence triage, clinical work-up, and disposition.
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spelling pubmed-64629682019-04-19 Combinations of Symptoms in Emergency Presentations: Prevalence and Outcome Kuster, Tobias Nickel, Christian H. Jenny, Mirjam A. Blaschke, Lana L. Bingisser, Roland J Clin Med Article The predictive power of certain symptoms, such as dyspnoea, is well known. However, research is limited to the investigation of single chief complaints. This is in contrast to patients in the emergency department (ED) presenting usually more than one symptom. We aimed to identify the most common combinations of symptoms and to report their related outcomes: hospitalisation, admission to intensive care units, and mortality. This is a secondary analysis of a consecutive sample of all patients presenting to the ED of the University Hospital Basel over a total time course of 6 weeks. The presence of 35 predefined symptoms was systematically assessed upon presentation. A total of 3960 emergency patients (median age 51, 51.7% male) were included. Over 130 combinations of two, 80 combinations of three, and 10 combinations of four symptoms occurred 42 times or more during a total inclusion period of 42 days. Two combinations of two symptoms were predictive for in-hospital mortality: weakness and fatigue (Odds ratio (OR) = 2.45), and weakness and headache (OR = 3.01). Combinations of symptoms were frequent. Nonspecific complaints (NSCs), such as weakness and fatigue, are among the most frequently reported combinations of symptoms, and are associated with adverse outcomes. Systematically assessing symptoms may add valuable information for prognosis and may therefore influence triage, clinical work-up, and disposition. MDPI 2019-03-12 /pmc/articles/PMC6462968/ /pubmed/30870989 http://dx.doi.org/10.3390/jcm8030345 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kuster, Tobias
Nickel, Christian H.
Jenny, Mirjam A.
Blaschke, Lana L.
Bingisser, Roland
Combinations of Symptoms in Emergency Presentations: Prevalence and Outcome
title Combinations of Symptoms in Emergency Presentations: Prevalence and Outcome
title_full Combinations of Symptoms in Emergency Presentations: Prevalence and Outcome
title_fullStr Combinations of Symptoms in Emergency Presentations: Prevalence and Outcome
title_full_unstemmed Combinations of Symptoms in Emergency Presentations: Prevalence and Outcome
title_short Combinations of Symptoms in Emergency Presentations: Prevalence and Outcome
title_sort combinations of symptoms in emergency presentations: prevalence and outcome
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6462968/
https://www.ncbi.nlm.nih.gov/pubmed/30870989
http://dx.doi.org/10.3390/jcm8030345
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