The 'Unwell' clinical presentation- an opportunity for admission avoidance?

Q3 Medicine

Acute Medicine Pub Date : 2022-01-01 DOI:10.52964/AMJA.0887

R. Conway, D. Byrne, D. O'Riordan, B. Silke

引用次数: 0

Abstract

BACKGROUND An 'unwell' patient is a common presentation. METHODS We studied all ED 'unwell' admissions over 6 years, assessing factors influencing mortality with logistic regression. RESULTS From 49,965 admissions, the ED diagnosis was 'unwell' in 3650 (7.3%). 'Unwell' presentations were older and had longer length of stay. Mortality was not different 4.2% vs 4.6 % (p=0.28). Respiratory patients and those >=70 years had increased mortality, 8.3% (95%CI: 5.9%, 10.6%) and 7.1% (5.7%, 8.4%) respectively. Being unwell predicted a better outcome - univariate OR 0.35 (95%CI: 0.24, 0.52), multivariable OR 0.68 (95%CI: 0.44, 1.03). CONCLUSION A diagnosis of 'unwell' applied to a heterogenous group; clinical trajectories and outcomes were sufficiently different to preclude targeted admission avoidance as a strategy.

查看原文本刊更多论文

“不适”的临床表现-逃避入院的机会?

背景“身体不适”的病人是常见的表现。方法我们研究了6年来所有ED“不适”入院患者，用逻辑回归法评估影响死亡率的因素。结果在49965例入院患者中，3650例（7.3%）的ED诊断为“不适”。“不舒服”的表现年龄较大，住院时间较长。死亡率分别为4.2%和4.6%（p=0.28）。呼吸系统患者和>=70岁患者的死亡率分别增加了8.3%（95%置信区间：5.9%，10.6%）和7.1%（5.7%，8.4%）。身体不适可预测更好的结果-单变量OR 0.35（95%CI:0.24052），多变量OR 0.68（95%CI=0.44,1.03）；临床轨迹和结果的差异足以排除作为一种策略的有针对性的入院回避。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Acute Medicine Medicine-Emergency Medicine

CiteScore

1.50

自引率

0.00%

发文量

期刊介绍： These are usually commissioned by the editorial team in accordance with a cycle running over several years. Authors wishing to submit a review relevant to Acute Medicine are advised to contact the editor before writing this. Unsolicited review articles received for consideration may be included if the subject matter is considered of interest to the readership, provided the topic has not already been covered in a recent edition. Review articles are usually 3000-5000 words and may include tables, pictures and other figures as required for the text. Include 3 or 4 ‘key points’ summarising the main teaching messages.