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Open AccessArticle

Combinations of Symptoms in Emergency Presentations: Prevalence and Outcome

Emergency Department, University Hospital Basel, Petersgraben 2, CH-4031 Basel, Switzerland
Harding Center for Risk Literacy, Max Planck Institute for Human Development, Lentzeallee 94, DE-14195 Berlin, Germany
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(3), 345;
Received: 11 January 2019 / Revised: 4 March 2019 / Accepted: 7 March 2019 / Published: 12 March 2019
(This article belongs to the Section Epidemiology & Public Health)
The predictive power of certain symptoms, such as dyspnoea, is well known. However, research is limited to the investigation of single chief complaints. This is in contrast to patients in the emergency department (ED) presenting usually more than one symptom. We aimed to identify the most common combinations of symptoms and to report their related outcomes: hospitalisation, admission to intensive care units, and mortality. This is a secondary analysis of a consecutive sample of all patients presenting to the ED of the University Hospital Basel over a total time course of 6 weeks. The presence of 35 predefined symptoms was systematically assessed upon presentation. A total of 3960 emergency patients (median age 51, 51.7% male) were included. Over 130 combinations of two, 80 combinations of three, and 10 combinations of four symptoms occurred 42 times or more during a total inclusion period of 42 days. Two combinations of two symptoms were predictive for in-hospital mortality: weakness and fatigue (Odds ratio (OR) = 2.45), and weakness and headache (OR = 3.01). Combinations of symptoms were frequent. Nonspecific complaints (NSCs), such as weakness and fatigue, are among the most frequently reported combinations of symptoms, and are associated with adverse outcomes. Systematically assessing symptoms may add valuable information for prognosis and may therefore influence triage, clinical work-up, and disposition. View Full-Text
Keywords: emergency medicine; emergency department; symptom-oriented research; nonspecific complaints; symptoms emergency medicine; emergency department; symptom-oriented research; nonspecific complaints; symptoms
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MDPI and ACS Style

Kuster, T.; Nickel, C.H.; Jenny, M.A.; Blaschke, L.L.; Bingisser, R. Combinations of Symptoms in Emergency Presentations: Prevalence and Outcome. J. Clin. Med. 2019, 8, 345.

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