Agreement Between Emergency Department Admission and Hospital Discharge Diagnoses; A Retrospective Observational Study
Introduction: An accurate emergency department (ED) diagnosis is critically important for providing proper treatment during the so-called “Golden Hour.” This study aimed to evaluate the agreement between admitting and discharge diagnoses in ED. Method: This retrospective cross-sectional study was...
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| Format: | Article |
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Shahid Beheshti University of Medical Sciences
2025-05-01
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| Series: | Archives of Academic Emergency Medicine |
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| Online Access: | https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/2597 |
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| author | Arif Ishtiq Mattoo Saad Al-shahrani Farhat Anjum Mattoo Saad Al-Asiri Amjad Obeid Donnie Neil Sarmiento Qasem Ahmed Almulihi Abdullah Saad Al-shahrani |
| author_facet | Arif Ishtiq Mattoo Saad Al-shahrani Farhat Anjum Mattoo Saad Al-Asiri Amjad Obeid Donnie Neil Sarmiento Qasem Ahmed Almulihi Abdullah Saad Al-shahrani |
| author_sort | Arif Ishtiq Mattoo |
| collection | DOAJ |
| description |
Introduction: An accurate emergency department (ED) diagnosis is critically important for providing proper treatment during the so-called “Golden Hour.” This study aimed to evaluate the agreement between admitting and discharge diagnoses in ED.
Method: This retrospective cross-sectional study was conducted over the course of 6 months in the emergency department (ED) of a tertiary care center. The main aim of the study was to evaluate the agreement between admission and hospital discharge diagnoses. The patients were categorized into two groups based on whether the admitting and discharge diagnoses were matched or mismatched. The reasons for diagnostic discrepancies, as well as their impact on patient outcomes, were assessed.
Results: A total of 6812 cases with mean age of 43.2 ± 17.9 (range: 1–95 years) years were included (59.30% male). The admitting and discharge diagnoses were matched in 5585 (81.99%) cases and mismatched in 1227 (18.01%) cases (7.2% were completely unmatched). The proportion of mismatched diagnoses did not differ significantly between males and females (p = 0.0977). Mismatched diagnoses were significantly more common in 0–15 years age group (37.86%), and the lowest proportion was seen in patients aged 15–65 years (9.65%) (p < 0.001). The most frequent reason for diagnostic discrepancy was “writing chronic disease as discharge diagnosis (relabeling),” (37.08%). Other contributing factors included radiological tests after hospital admission (20.37%), physical examination findings (18.1%), additional laboratory tests (15.81%), and other causes (8.57%). A change in diagnosis impacted the clinical outcomes of 103 (8.39%) patients.
Conclusion: Diagnostic agreement between ED and discharge diagnoses was observed in 81.99% of cases, with a 7.2% complete mismatch rate. The most frequent causes were discharge relabeling and delayed investigations. These discrepancies had measurable impacts on management, hospital stay, and mortality.
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| format | Article |
| id | doaj-art-2a1dd5fabaa9444d932a85e6be707b8a |
| institution | OA Journals |
| issn | 2645-4904 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Shahid Beheshti University of Medical Sciences |
| record_format | Article |
| series | Archives of Academic Emergency Medicine |
| spelling | doaj-art-2a1dd5fabaa9444d932a85e6be707b8a2025-08-20T02:34:36ZengShahid Beheshti University of Medical SciencesArchives of Academic Emergency Medicine2645-49042025-05-0113110.22037/aaemj.v13i1.2597Agreement Between Emergency Department Admission and Hospital Discharge Diagnoses; A Retrospective Observational StudyArif Ishtiq Mattoo0Saad Al-shahrani 1Farhat Anjum Mattoo2Saad Al-Asiri3Amjad Obeid4Donnie Neil Sarmiento5Qasem Ahmed Almulihi6Abdullah Saad Al-shahrani7Department of Emergency Medicine Dr Sulaiman AlHabib Hospital (HMG), Al-Khobar, Kingdom of Saudi Arabia.Department of Emergency Medicine Dr Sulaiman AlHabib Hospital (HMG), Al-Khobar, Kingdom of Saudi Arabia.Department of Emergency Medicine Dr Sulaiman AlHabib Hospital (HMG), Al-Khobar, Kingdom ofDepartment of Emergency Medicine Dr Sulaiman AlHabib Hospital (HMG) Corporate office), Al-Khobar, Kingdom of Saudi Arabia.Department of Emergency Medicine Dr Sulaiman AlHabib Hospital (HMG), Al-Khobar, Kingdom of Saudi Arabia.Department of Emergency Medicine Dr Sulaiman AlHabib Hospital (HMG), Al-Khobar, Kingdom ofDepartment of Emergency Medicine - King Fahad Hospital - University of Imam Abdulrahman bin Faisal, Al-Khobar, Kingdom of Saudi ArabiaDepartment of Emergency Medicine - King Fahad Hospital - University of Imam Abdulrahman bin Faisal, Al-Khobar, Kingdom of Saudi Arabia Introduction: An accurate emergency department (ED) diagnosis is critically important for providing proper treatment during the so-called “Golden Hour.” This study aimed to evaluate the agreement between admitting and discharge diagnoses in ED. Method: This retrospective cross-sectional study was conducted over the course of 6 months in the emergency department (ED) of a tertiary care center. The main aim of the study was to evaluate the agreement between admission and hospital discharge diagnoses. The patients were categorized into two groups based on whether the admitting and discharge diagnoses were matched or mismatched. The reasons for diagnostic discrepancies, as well as their impact on patient outcomes, were assessed. Results: A total of 6812 cases with mean age of 43.2 ± 17.9 (range: 1–95 years) years were included (59.30% male). The admitting and discharge diagnoses were matched in 5585 (81.99%) cases and mismatched in 1227 (18.01%) cases (7.2% were completely unmatched). The proportion of mismatched diagnoses did not differ significantly between males and females (p = 0.0977). Mismatched diagnoses were significantly more common in 0–15 years age group (37.86%), and the lowest proportion was seen in patients aged 15–65 years (9.65%) (p < 0.001). The most frequent reason for diagnostic discrepancy was “writing chronic disease as discharge diagnosis (relabeling),” (37.08%). Other contributing factors included radiological tests after hospital admission (20.37%), physical examination findings (18.1%), additional laboratory tests (15.81%), and other causes (8.57%). A change in diagnosis impacted the clinical outcomes of 103 (8.39%) patients. Conclusion: Diagnostic agreement between ED and discharge diagnoses was observed in 81.99% of cases, with a 7.2% complete mismatch rate. The most frequent causes were discharge relabeling and delayed investigations. These discrepancies had measurable impacts on management, hospital stay, and mortality. https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/2597Emergency service, hospitalDiagnosis, differentialDiagnostic errorsHospital recordsRetrospective studies |
| spellingShingle | Arif Ishtiq Mattoo Saad Al-shahrani Farhat Anjum Mattoo Saad Al-Asiri Amjad Obeid Donnie Neil Sarmiento Qasem Ahmed Almulihi Abdullah Saad Al-shahrani Agreement Between Emergency Department Admission and Hospital Discharge Diagnoses; A Retrospective Observational Study Archives of Academic Emergency Medicine Emergency service, hospital Diagnosis, differential Diagnostic errors Hospital records Retrospective studies |
| title | Agreement Between Emergency Department Admission and Hospital Discharge Diagnoses; A Retrospective Observational Study |
| title_full | Agreement Between Emergency Department Admission and Hospital Discharge Diagnoses; A Retrospective Observational Study |
| title_fullStr | Agreement Between Emergency Department Admission and Hospital Discharge Diagnoses; A Retrospective Observational Study |
| title_full_unstemmed | Agreement Between Emergency Department Admission and Hospital Discharge Diagnoses; A Retrospective Observational Study |
| title_short | Agreement Between Emergency Department Admission and Hospital Discharge Diagnoses; A Retrospective Observational Study |
| title_sort | agreement between emergency department admission and hospital discharge diagnoses a retrospective observational study |
| topic | Emergency service, hospital Diagnosis, differential Diagnostic errors Hospital records Retrospective studies |
| url | https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/2597 |
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