Non-specific diagnoses are frequent in patients hospitalized after calling 112 and their mortality is high - a register-based Danish cohort study.
BACKGROUND
The number of patients calling for an ambulance increases. A considerable number of patients receive a non-specific diagnosis at discharge from the hospital, and this could imply less serious acute conditions, but the mortality has only scarcely been studied. The aim of this study was to examine the most frequent sub-diagnoses among patients with hospital non-specific diagnoses after calling 112 and their subsequent mortality.


METHODS
A historical cohort study of patients brought to the hospital by ambulance after calling 112 in 2007-2014 and diagnosed with a non-specific diagnosis, chapter R or Z, in the International Classification of Diseases, 10th edition (ICD-10). 1-day and 30-day mortality was analyzed by survival analyses and compared by the log-rank test.


RESULTS
We included 74,847 ambulance runs in 53,937 unique individuals. The most frequent diagnoses were 'unspecified disease' (Z039), constituting 47.0% (n 35,279). In children 0-9 years old, 'febrile convulsions' was the most frequent non-specific diagnosis used in 54.3% (n 1602). Overall, 1- and 30-day mortality was 2.2% (n 1205) and 6.0% (n 3258). The highest mortality was in the diagnostic group 'suspected cardiovascular disease' (Z035) and 'unspecified disease' (Z039) with 1-day mortality 2.6% (n 43) and 2.4% (n 589), and 30 day mortality of 6.32% (n 104) and 8.1% (n 1975).


CONCLUSION
Among patients calling an ambulance and discharged with non-specific diagnoses the 1- and 30-day mortality, despite modest mortality percentages lead to a high number of deaths.
['Nielsen|Frederikke Vestergaard|FV|http://orcid.org/0000-0002-9097-126X', 'Nielsen|Mette Rønn|MR|', 'Amstrup|Jesper|J|', 'Lorenzen|Ida Lund|IL|', 'Kløjgaard|Torben A|TA|', 'Færk|Emil|E|', 'Bøggild|Henrik|H|', 'Christensen|Erika Frischknecht|EF|']
D000293:Adolescent D000328:Adult D017677:Age Distribution D000368:Aged D000369:Aged, 80 and over D000552:Ambulances D002648:Child D002675:Child, Preschool D015331:Cohort Studies D003718:Denmark D004631:Emergency Medical Service Communication Systems D005260:Female D006801:Humans D007223:Infant D007231:Infant, Newborn D038801:International Classification of Diseases D008297:Male D008875:Middle Aged D009026:Mortality D010351:Patient Discharge D012042:Registries D017678:Sex Distribution D055815:Young Adult
Non-specific diagnoses Mortality Ambulances Emergency medical services Outcome