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Table 1 Scheme to classify a pair of diagnoses from ER (admission) and IM (discharge), extended from [46]

From: Diagnostic error increases mortality and length of hospital stay in patients presenting through the emergency room

Outcome Discharge Diagnosis is Frequency Explanation Example
Without diagnostic discrepancy Identical 436 (57.7%) The two diagnoses are either verbatim or medically identical.
More precise 190 (25.2%) The IM discharge diagnosis is more precise than the ER diagnosis (e.g., by adding an established, disease-specific score or the result of a test that was not available at the ER). ER diagnosis: atrial Fibrillation
IM diagnosis: atrial Fibrillation,
CHADS2-Score 4
A complication 36 (4.8%) The primary discharge diagnosis from the IM was not foreseeable at the time of hospital admission at the ER but became the most prominent during hospitalization. ER diagnosis: hospital acquired Pneumonia
IM diagnosis:
1) acute septic ischemia of both legs
2) Legionella pneumonia
With diagnostic discrepancy Hierarchically different 25 (3.3%) The primary ER diagnosis is listed among the IM discharge diagnoses but is not the primary discharge diagnosis. ER diagnosis:
1) Recurrent falls 2) Gastroenteritis
IM diagnosis: 1) Femoral neck fracture*
2) Recurrent falls 3) Gastroenteritis
Diagnostically different 68 (9.0%) The primary ER diagnosis is not among the IM discharge diagnoses. ER diagnosis: acute on chronic obstipation
IM diagnosis: acute pancreatitis
  1. *No further falls after admittance. ER: emergency room; IM: internal medicine