Non-specific Complaints

Background, symptoms and solutions

Rapid risk stratification of getriatric patients with non-specific complaintsMR-proADM can aid in the rapid and accurate risk assessment of geriatric patients with non-specific complaints on hospital admission, and can lead to significant patient and healthcare provider benefits, such as a reduction in acute ward and higher intensity admissions, an increase in out-patient treatment, and a reduction in physician time for patient evaluation, without adversely affecting patient outcome or health.

 

Non-specific complaints: A major clinical and economical problem

Due to a globally ageing population, particularly in those aged 75 and above1, emergency departments are becoming increasingly over-crowded, with patients facing prolonged waiting times and a shortage of available spaces. To compound matters, 1 in 5 elderly patients present to the ED with a generalized feeling of illness that cannot be easily defined. Accordingly, a variety of terms have been formulated to describe the condition, such as nebulous2, unclear3, vague4, 5, silent5, atypical6, 7, complex8, and non-specific3.

The subsequent evaluation and diagnostic work-up of these elderly patients can be very time consuming due to the absence of classical diagnostic symptoms, an atypical presentation of common diseases9, and additional factors such as comorbidities, polypharmacy, altered mental status, and poor communication10, 11. Indeed, the underlying cause of morbidity can often range from insufficient home care, to acute, life threatening conditions12, 13, thus adding a further degree of diagnostic complexity.

Consequently, an amalgamation of these issues can lead to inaccurate triage, longer diagnostic work-ups and adverse health outcomes14, 15, resulting in an extremely broad diagnosis and acute morbidity in almost 60 % of cases11, 16. This not only exacerbates the already significant issues currently faced in the ED, but can also represent a potential risk to the patient if discharged or hospitalized unnecessarily17, 18.

Therefore, a safe and rapid triaging of patients is essential in improving the workflow within the ED, maximizing patient safety and comfort, and alleviating any unnecessary financial burden from the healthcare provider19.

Non-specific complaints: poorly defined symptoms can include20:

mr-proadm-nsc-symptomes

A more precise tool for optimal triage and risk stratification is urgently needed

Diagnostic and treatment protocols on ED admission exist for many conditions where the chief complaints are known, such as in acute pain, dysponea, and flank pain21-23. However, no comparable diagnosis protocols exist for non-specific complaints11.

Indeed, the only methods currently used for assessing the risk and severity of non-specific complaints on admission include the general Emergency Severity Index (ESI) and Glasgow Coma Scale (GCS) scores, however, even after observation, optimal triage is not achieved as large numbers of patients with potentially serious outcomes are transferred to non-acute wards or settings, or those without serious morbidity risks are admitted to an acute ward24.

Therefore, using such tools, patients suffering from non-specific complaints are at a high risk of being transferred to an inappropriate site of treatment, which may lead to an increased risk of adverse health outcomes24, and an unnecessary financial burden on the clinical setting.

Accordingly, more accurate triage and risk stratification tools are urgently needed for patients presenting to the ED with non-specific complaints24.

 

The solution: MR-proADM – Fast, accurate, independent

MR-proADM can rapidly make an accurate assessment of the risk to a patient’s health upon hospital admission, thus minimizing the need for time consuming physician work-up and diagnostic testing for patients at no immediate risk.
This, in turn, allows time and resources to be spent on patients who require the highest level of care most urgently.

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