Characteristics and mortality of patients categorised with non-specific symptoms when dialling the emergency medical number: a register-based cohort study.

Background: Medical communication centre operators of the 1-1-3 medical emergency number in Norway use the decision support tool, the Norwegian Index for Medical Emergency, to categorise the problem and determine the correct handling and urgency level of the situation. The index comprises 42 chapters, one of which is titled 'Non-specific problem'. Studies in Denmark frequently use this chapter; however, there are no published Norwegian studies on the demographics of this patient group. Thus, we investigated the characteristics of the patients assigned to this chapter and their 1- and 30-day mortality outcomes.

Methods: This was a registry-based, retrospective cohort study. Descriptive statistics were used to compare the two groups; t-tests were performed for continuous variables, and data were presented with corresponding 95% confidence intervals. Categorical data were compared using the chi-square test. Statistical significance was set at p < 0.05.

Results: Out of the 25,474 included calls to the emergency medical communication centre in 2022, 1,860 (7.3%) were categorised as 'Non-specific problem'. Patients in this group had a higher mean age, were more often men, had a shorter hospital stay, and showed more comorbidities than the control group. The use of this chapter was associated with the allocation of a higher urgency level, and a reduction in the use of these criteria was observed during nighttime. Significantly higher 1- and 30-day mortality rates were observed in patients with non-specific symptoms (1.40% and 6.94%, respectively; p < 0.05).

Conclusions: The group presenting symptoms categorised as non-specific comprised older patients, more men, and a higher number of patients showing comorbidities than the control group. Patients presenting symptoms categorised as non-specific typically perceived a high level of urgency. Most of these patients had a non-specific main diagnosis after hospital admission and a significantly higher mortality rate than those presenting with symptoms categorised as specific.

Clinical trial number: Not applicable.