Prospective evaluation of patients hospitalized from the emergency department

After the initial diagnose and treatment of emergency department some patients have discharged but some patients has to be hospitalized and further diagnostic process and treatment has to be continued. There are so many reviews in the literature about missed injuries and missed diagnoses during the initial assessment in trauma patients but non-trauma patients has few reviews about missed diagnoses and missed injuries. This study was done prospectively by using the non-trauma patient's data that first has admitted Akdeniz University Emergency department then were hospitalized between 1 December 2014 and 2 February 2015. We had 740 non-trauma patients enrolled in this study. In our study the hospitalization rate was 10.3%, female rate was 51.6% and the average age was 52.3 years old. Obstetrics and Gynecology Clinic has the most hospitalization ratio about 17.7%. Because there is a gynecology room in the emergency department and most of the cases are labor and it is easy to follow up. The other hospitalization ratios were similar to the literature. The rate of patient who has missed diagnoses was 2.9% and the most difficult symptom which causes the missed diagnose was abdominal pain. There were 3 patients who died from the progression of their illnesses and those patients have severe malignant diseases. These patients have similar emergency admitting symptoms and follow-up symptoms. So as a result if a patient has a severe and chronic medical condition it is hard to make a differential diagnose at a clinic like emergency department. Emergency department is a place where too many patients has treatment and has hospitalized. In a place like that if the initial diagnose and the discharge treatment were similar, it will be said that there is adequate physical examination, adequate laboratory testing and adequate consultation has been done.