• Richard Conway, Declan Byrne, Deirdre O'Riordan, and Bernard Silke.
• Department of Internal Medicine, St James's Hospital, Dublin 8, Ireland.
• Eur. J. Intern. Med. 2021 May 1; 87: 75-82.

AimTo investigate whether a specific (SP) or non-specific (NSP) clinical presentation, predicts prognosis and in-hospital resource utilization in emergency medical admissions.MethodsWe studied admissions over 5 years (2015-2019) and classified the symptom presentation as SP or NSP. The predictive capacity of the NSP category was related to 30-day in-hospital mortality with a multivariable logistic regression model. Utilization of procedures/services was related to hospital length of stay (LOS) with zero truncated Poisson regression.ResultsThere were 39,776 admissions in 23,995 patients. A NSP occurred in 18.2% of our top 20 clinical presentations; the top five being shortness of breath (12.8%), 'unwell' (7.1%), collapse (4.1%), abdominal pain (3.6%) and headache (2.7%). Baseline demographic characteristics were similar and unrelated to type of presentation; the model adjusted mortality by SP 4.0% (95% CI: 3.8%, 4.2%) or NSP 3.9% (95% CI: 3.5%, 4.4%) was identical. LOS was a dependant quantitative function of procedures/services undertaken; for the top two presentations of shortness of breath (SP) or unwell (NSP) there was no relationship between a SP or NSP presentation and hospital utilization of procedures/services or LOS.ConclusionOur data suggest no utility for a categorisation of presentations as specific or non-specific in terms of provision of prognostic information nor as an indicator of the pattern of hospital investigation or LOS.Copyright © 2021. Published by Elsevier B.V.

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