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. 2024 Mar 13;16(3):e56083.
doi: 10.7759/cureus.56083. eCollection 2024 Mar.

The Value of Emergency Care Data Set (ECDS) Presentation Codes for Predicting Mortality and Inpatient Admission

Betsy Teresa  1 , Mohammed Subhi  2 , Adrian Boyle  1 , Wayne Kark  1
Affiliations

The Value of Emergency Care Data Set (ECDS) Presentation Codes for Predicting Mortality and Inpatient Admission

Betsy Teresa et al. Cureus. .

Abstract

Background: Early identification of patients at higher risk of death and hospital admission is an important problem in Emergency Departments (ED). Most triage scales were developed before current electronic healthcare records were developed. The implementation of a national Emergency Care Data Set (ECDS) allows for the standardised recording of presenting complaints and the use of Electronic Patient Records (EPR) offers the potential for automated triage. The mortality risk and need for hospital admission associated with the different presenting complaints in a standardised national data set has not been previously reported. This study aimed to quantify the risks of death and hospitalisation from presenting complaints. This would be valuable in developing automated triage tools and decision support software.

Methods: We conducted an observational retrospective cohort study on patients who visited a single ED in 2021. The presenting complaints related to subsequent attendances were excluded. This patient list was then manually matched with a routinely collected list of deaths. All deaths that occurred within 30 days of attendance were included.

Results: Data was collected from 84,999 patients, of which 1,159 people died within 30 days of attendance. The mortality rate was the highest in cardiac arrest [32 (78.1%)], cardiac arrest due to trauma [2(50%)] and respiratory arrest [3(50%)]. Drowsy [17(12%)], hypothermia [3(13%)] and cyanosis [1(10%)] were also high-risk categories. Chest pain [34(0.6%)] was not a high-risk presenting complaint.

Conclusion: The initial presenting complaint in ECDS may be useful to identify people at higher and lower risk of death. This information is useful for building automated triage models.

Keywords: ecds; hospital admission; mortality; news2 score; presenting complaints; triage.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Probability of death within 24 hours by ECDS chief complaint (% [95% CI])
Data in the x-axis represents the deaths that occurred within 24 hours of attendance and are shown as % [CI]. The y-axis corresponds to the ECDS chief complaints. CI = Confidence interval, ECDS = Emergency Care Data Set
Figure 2
Figure 2. The NEWS2 scoring system
NEWS = National Early Warning Score
See this image and copyright information in PMC

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References

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