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Predicting admission of patients by their presentation to the emergency department
Author(s) -
Kim Susan W,
Li Jordan Y,
Hakendorf Paul,
Teubner David JO,
BenTovim David I,
Thompson Campbell H
Publication year - 2014
Publication title -
emergency medicine australasia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.602
H-Index - 52
eISSN - 1742-6723
pISSN - 1742-6731
DOI - 10.1111/1742-6723.12252
Subject(s) - medicine , triage , emergency department , referral , disposition , logistic regression , emergency medicine , presentation (obstetrics) , retrospective cohort study , observational study , tertiary referral hospital , hospital admission , family medicine , surgery , nursing , psychology , social psychology
Objective The present study aims to determine the importance of certain factors in predicting the need of hospital admission for a patient in the ED . Methods This is a retrospective observational cohort study between J anuary 2010 and M arch 2012. The characteristics, including blood test results, of 100 123 patients who presented to the ED of a tertiary referral urban hospital, were incorporated into models using logistic regression in an attempt to predict the likelihood of patients' disposition on leaving the ED . These models were compared with triage nurses' prediction of patient disposition. Results Patient age, their initial presenting symptoms or diagnosis, A ustralasian T riage S cale category, mode of arrival, existence of any outside referral, triage time of day and day of the week were significant predictors of the patient's disposition ( P < 0.001). The ordering of blood tests for any patient and the extent of abnormality of those tests increased the likelihood of admission. The accuracy of triage nurses' admission prediction was similar to that offered by a model that used the patients' presentation characteristics. The addition of blood tests to that model resulted in only 3% greater accuracy in prediction of patient disposition. Conclusions Certain characteristics of patients as they present to hospital predict their admission. The accuracy of the triage nurses' prediction for disposition of patients is the same as that afforded by a model constructed from these characteristics. Blood test results improve disposition accuracy only slightly so admission decisions should not always wait for these results.