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Observational Study
. 2018 Jul 13;18(1):548.
doi: 10.1186/s12913-018-3361-x.

Diagnosis and mortality of emergency department patients in the North Denmark region

Morten Breinholt Søvsø  1 , Sabina Bay Hermansen  2 , Emil Færk  2 , Tim Alex Lindskou  2 , Marc Ludwig  3 , Jørn Munkhof Møller  4 , Jelena Jonciauskiene  5 , Erika Frischknecht Christensen  2   6
Affiliations
Observational Study

Diagnosis and mortality of emergency department patients in the North Denmark region

Morten Breinholt Søvsø et al. BMC Health Serv Res. .

Abstract

Background: Emergency departments handle a large proportion of acute patients. In 2007, it was recommended centralizing the Danish healthcare system and establishing emergency departments as the main common entrance for emergency patients. Since this reorganization, few studies describing the emergency patient population in this new setting have been carried out and none describing diagnoses and mortality. Hence, we aimed to investigate diagnoses and 1- and 30-day mortality of patients in the emergency departments in the North Denmark Region during 2014-2016.

Methods: Population-based historic cohort study in the North Denmark Region (580,000 inhabitants) of patients with contact to emergency departments during 2014-2016. The study included patients who were referred by general practitioners (daytime and out-of-hours), by emergency medical services or who were self-referred. Primary diagnoses (ICD-10) were retrieved from the regional Patient Administrative System. For non-specific diagnoses (ICD-10 chapter 'Symptoms and signs' and 'Other factors'), we searched the same hospital stay for a specific diagnosis and used this, if one was given. We performed descriptive analysis reporting distribution and frequency of diagnoses. Moreover, 1- and 30-day mortality rate estimates were performed using the Kaplan-Meier estimator.

Results: We included 290,590 patient contacts corresponding to 166 ED visits per 1000 inhabitants per year. The three most frequent ICD-10 chapters used were 'Injuries and poisoning' (38.3% n = 111,274), 'Symptoms and signs' (16.1% n = 46,852) and 'Other factors' (14.52% n = 42,195). Mortality at day 30 (95% confidence intervals) for these chapters were 0.86% (0.81-0.92), 3.95% (3.78-4.13) and 2.84% (2.69-3.00), respectively. The highest 30-day mortality were within chapters 'Neoplasms' (14.22% (12.07-16.72)), 'Endocrine diseases' (8.95% (8.21-9.75)) and 'Respiratory diseases' (8.44% (8.02-8.88)).

Conclusions: Patients in contact with the emergency department receive a wide range of diagnoses within all chapters of ICD-10, and one third of the diagnoses given are non-specific. Within the non-specific chapters, we found a 30-day mortality, surpassing several of the more organ specific ICD-10 chapters.

Trial registration: Observational study - no trial registration was performed.

Keywords: Delivery of healthcare; Denmark; Emergency department; Mortality; Non-specific diagnoses; Reorganization of healthcare.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the Danish Data Protection Agency (North Denmark Region record number 2008–58-0028 and project identification number 2017–70). Informed consent from patients is not required for registry-based studies according to Danish law.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow chart for patient contacts included in the study
Fig. 2
Fig. 2
Patient age and sex distribution at time of ED contact
Fig. 3
Fig. 3
Top five most frequent ICD-10 chapters and patient age distribution at time of ED contact
See this image and copyright information in PMC

References

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