• Zvi Shimoni, Abu D Firas, Vered Hermush, and Paul Froom.
• Israel and Sanz Medical Centre, Laniado Hospital, The Adelson School of Medicine -Ariel University, Netanya, Israel.
• J Eval Clin Pract. 2024 Oct 13.

Rationale And ObjectiveOlder adults in the Emergency Department (ED) often present with nonspecific complaints (NSC) that might be associated with adverse health outcomes due to underestimating the seriousness of the illness by health care workers.MethodsWe selected a random sample of patients aged 65 or older who complained of weakness and were hospitalised in internal medicine departments in 2019-2021. We divided the patients into those with and without specific reasons for hospitalisation after the ED evaluation. Outcome variables included changes in medical care based on CT head scans and blood tests, and whether a delay in diagnosis led to a longer stay, in-hospital mortality, or readmission within 30 days.ResultsPatients were aged 82 ± 8 years and 43.6% (233/536)were female. 46.8% (260/556) of the patients had a specific reason for hospitalisation after the ED evaluation including four patients presenting with confusion, without neurological findings but with acute ischaemia found on the brain CT. Patients without a specific presentation had fewer blood tests done due to a significantly shorter hospital stay (median (1st-3rd quartiles: 3 (2-4) vs. 4 (3-6) days, p < 0.001), a lower mortality rate, 0.3% (n = 1) compared to 4.2% (n = 11), p = 0.002), and fewer readmissions 13.5%(n = 40) compared to 20.4% (n = 53). The deaths and readmissions in both groups were not due to a delay in diagnosis.ConclusionsElderly patients with a chief complaint of weakness with and without a specific reason for hospitalisation were not at an increased risk for inappropriate treatment or a missed diagnosis.© 2024 The Author(s). Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd.

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