PriMera Scientific Surgical Research and Practice (ISSN: 2836-0028)

Research Article

Volume 2 Issue 2

Discharge Diagnosis vs Emergency Diagnosis, an Retrospective Study

Denada Selfo*

July 29, 2023

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Abstract

The aim of this study is to investigate the matching between emergency department and discharge diagnosis as well as how investigations affect accurately of emergency department diagnosis. One of the primary consequences of inconsistent diagnosis is the prolongation of hospital stays. The process of diagnosis entails identifying the illness that is the source of a patient's symptoms and warning signs. Investigations, the physical examination, and the history all play a significant role in making a successful initial diagnosis. The study was conducted retrospectively over a seven-month period in 2019 including four in-patient specialties: orthopedics, surgery, and medicine. All patients that entered the emergency room during the study period. The diagnostic accuracy was shown to be considerably higher in the younger age group when the adult patients were divided into groups by age (19-62 years versus 65 years or above, p value less than 0.001). 74% of diagnoses at admission completely or partially matched diagnoses at discharge. Traumatized cases and young people had significantly superior diagnosis accuracy, according to data. Improvements in ED diagnostic definitely needed, particularly for nontrauma situations, young patients, and the elderly. Patient history and clinical examination are the two tools that one may use to increase the accuracy of an ED diagnosis. Diagnoses such as chest illness, hip fracture, and injuries to the finger, leg, or foot were considered partial matches. Simple tests available in the ER were frequently ineffective at improving diagnostic accuracy.

Keywords: Emergency diagnosis; Traumatized cases; ER; investigations

References

  1. Preston CA., et al. “Reduction of "callbacks" to the ED due to discrepancies in plain radiograph interpretation”. Am J Emerg Med 16.2 (1998): 160-2.
  2. Fleisher G, Ludwig S and McSorley M. “Interpretation of pediatric x-ray films by emergency department pediatricians”. Ann Emerg Med 12.3 (1983): 153-8.
  3. Johnson T., et al. “Discrepancy between admission and discharge diagnoses as a predictor of hospital length of stay”. J Hosp Med 4.4 (2009): 234-239.
  4. Chiu HS., et al. “A comparison of emergency department admission diagnoses and discharge diagnoses: retrospective study”. Hong Kong Journal of emergency medicine 10.2 (2003): 70-75.‏
  5. Leape LL., et al. “The nature of adverse events in hospitalized patients. Results of the Harvard Medical Practice Study II”. N Engl J Med 324.6 (1991): 377-384.
  6. George JE, Espinosa JA and Quattrone MS. “Legal issues in emergency radiology. Practice strategies to reduce risk”. Emerg Med Clin North Am 10.1 (1992): 197-203.
  7. McNutt R., et al. “Cost and quality implications of discrepancies between admitting and discharge diagnoses”. Qual Manag Health Care 21.4 (2012): 220-227.
  8. Kizer KW and Vassar MJ. “Emergency department diagnosis of abdominal disorders in the elderly”. Am J Emerg Med 16.4 (1998): 357-62.
  9. Lim GH., et al. “Study on the discrepancies between the admitting diagnoses from the emergency department and the discharge diagnoses”. Hong Kong J Emerg Med 9.2 (2002): 78-82.‏