TY - JOUR T1 - Predicting mortality and readmission based on chief complaint in emergency department patients: a cohort study JF - Trauma Surgery & Acute Care Open JO - Trauma Surg Acute Care Open DO - 10.1136/tsaco-2020-000604 VL - 6 IS - 1 SP - e000604 AU - Søren Flink Sørensen AU - Stig Holm Ovesen AU - Marianne Lisby AU - Mia Hansen Mandau AU - Ida Katrine Thomsen AU - Hans Kirkegaard Y1 - 2021/12/01 UR - http://tsaco.bmj.com/content/6/1/e000604.abstract N2 - Background Emergency department (ED) patients present with complaints and not diagnoses. Characterization and risk stratification based on chief complaint can therefore help clinicians improve ED workflow and clinical outcome. In this study we investigated the 30-day mortality and readmission among ED patients based on chief complaint.Methods In this cohort study we retrieved routinely collected data from electronic medical records and the Danish Civil Registration System of all ED contacts from July 1, 2016 through June 30, 2017. All patients triaged with one chief complaint using the Danish Emergency Process Triage system were included. Patients with minor injuries were excluded. The chief complaint assigned by the triaging nurse was used as exposure, and 30-day mortality and 30-day readmission were the primary outcomes. Logistic regression was used to determine crude and adjusted ORs with reference to the remaining study population.Results A total of 41 470 patients were eligible. After exclusion of minor injuries and patients not triaged, 19 325 patients were included. The 30-day mortality and 30-day readmission differed significantly among the chief complaints. The highest 30-day mortality was observed among patients presenting with altered level of conscousness (ALOC) (8.4%, OR=2.0, 95% CI 1.3 to 3.1) and dyspnea (8.0%, OR=2.1, 95% CI 1.6 to 2.6). 30-day readmission was highest among patients presenting with fever/infection (11.7%, OR=1.9, 95% CI 1.4 to 2.4) and dyspnea (11.2%, OR=1.7, 95% CI 1.4 to 2.0).Discussion Chief complaint is associated with 30-day mortality and readmission in a mixed ED population. ALOC and dyspnea had the highest mortality; fever/infection and dyspnea had the highest readmission rate. This knowledge may assist in improving and optimizing symptom-based initial diagnostic workup and treatment, and ultimately improve workflow and clinical outcome.Level of evidence Level III.Data are available upon reasonable request. Data are stored on a local server. The owner of the data is Professor Hans Kirkegaard (hans.kirkegaard@clin.au.dk). Anonymized data can be accessed upon request. Raw data, cleaned data and cleaning protocols are available. ER -