Objective:

To investigate the association between emergency diagnoses and 1-year mortality across various noncancer conditions.

Approach:

• Study Design: Linked primary care, hospital, and mortality records were analyzed from 1.7 million patients diagnosed with 13 non-neoplastic conditions from 1999 to 2019.
• Conditions Studied: Conditions included axial spondyloarthritis, celiac disease, coronary heart disease, COPD, IBD, Lyme disease, MS, Parkinson's disease, polyendocrine metabolic ovarian syndrome, rheumatoid arthritis, schizophrenia, subacute bacterial endocarditis, and tuberculo…
• Emergency Diagnosis Definition: Defined as a diagnosis occurring on the day of or within 30 days following the start of an emergency hospital admission.
• Data Analysis: Models adjusted for age, year of diagnosis, deprivation, comorbidity burden, and diagnosis source.

Key Findings:

• Emergency diagnoses occurred in at least 20% of patients for nine conditions, including more than 30% of those with Parkinson's disease and 35% of those with COPD.
• 1-year mortality was at least 10 percentage points higher for emergency diagnoses in nine conditions.
• Male participants with axial spondyloarthritis had 20% mortality vs. 2% for non-emergency diagnoses.
• Emergency diagnosis was associated with longer hospital stays, e.g., male celiac disease patients spent a mean of 19 nights vs. 2 nights.

Interpretation:

Emergency diagnoses are linked to higher mortality and longer hospital stays across various noncancer conditions.

Limitations:

• Inability to determine if emergency diagnosis contributed to poorer outcomes.
• Potential differences in disease severity and characteristics not fully captured.
• Reliance on accurate recording of diagnoses and dates.

Conclusion:

Patients diagnosed as emergencies are more likely to experience higher mortality and longer hospital stays.

Sources:

• PLOS Medicine