Background. Emergency physicians (EPs) face critical admission decisions, and their judgments are questioned in some developing\nsystems. This study aims to define the factors affecting mortality in patients admitted to the hospital by EPs against inservice\ndepartmentsâ?? decision and evaluate EPsâ?? admission diagnosis with final discharge diagnosis. Methods. This is a retrospective\nanalysis of prospectively collected data of ten consecutive years (2008â??2017) of an emergency department of a university\nmedical center. Adult patients (more than or equal to18 years-old) who were admitted to the hospital by EPs against in-service departmentsâ?? decision\nwere enrolled in the study. Significant factors affecting mortality were defined by the backward logistic regression model. Results.\n369 consecutive patients were studied, and 195 (52.8%) were males. The mean (SD) age was 65.5 (17.3) years. The logistic\nregression model showed that significant factors affecting mortality were intubation (p < 0.0001), low systolic blood pressure\n(p = 0.006), increased age (p = 0.013), and having a comorbidity (p = 0.024). There was no significant difference between EPsâ??\nprimary admission diagnosis and patientâ??s final primary diagnosis at the time of disposition from the admitted departments\n(McNemarâ??Bowker test, p =0.45). 96% of the primary admission diagnoses of EPs were correct. Conclusions. Intubation, low\nsystolic blood pressure on presentation, increased age, and having a comorbidity increased the mortality. EPs admission diagnoses\nwere highly correlated with the final diagnosis. EPs make difficult admission decisions with high accuracy, if needed.
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