Table 2.
Description of the development and external validation cohorts. Baseline characteristics were compared by the chi-square test for categorical data and by the Kruskal-Wallis test for continuous data.
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Development (n=824) | Temporal validation (n=350) | Geographic validation (n=119) | P value | ||||||
| Study period | 2017-2019 | 2021-2022 | 2022 | —a | ||||||
| Patient-related factors | ||||||||||
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Sex, n (%) | |||||||||
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Female | 385 (46.7) | 199 (56.9) | 66 (55.5) | .003 | ||||
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Age (years), median (IQR) | 69 (55-80) | 67 (55-79) | 69 (55-78) | .91 | |||||
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Language, n (%) | .68 | ||||||||
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Dutch | 810 (98.3) | 347 (99.1) | 118 (99.2) |
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French | 11 (1.3) | 3 (0.9) | 1 (0.8) |
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English | 3 (0.4) | 0 (0) | 0 (0) |
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Residence before admission, n (%) | .37 | ||||||||
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Home | 798 (95.8) | 341 (97.4) | 116 (97.5) |
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Nursing home | 29 (3.5) | 9 (2.6) | 2 (1.7) |
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Other | 6 (0.7) | 0 (0) | 1 (0.8) |
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ESIbtriage score, n (%) | <.001 | ||||||||
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1 | 1 (0.1) | 5 (1.4) | 0 (0) |
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2 | 117 (14.2) | 102 (29.1) | 14 (11.8) |
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3 | 175 (21.2) | 116 (33.1) | 91 (76.5) |
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4 | 14 (21.7) | 19 (5.4) | 14 (11.8) |
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5 | 3 (0.4) | 1 (0.3) | 0 (0) |
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Unknown | 75 (9.1) | 107 (30.6) | 0 (0) |
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Transport to the EDc, n (%) | <.001 | ||||||||
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Patient’s own transport | 706 (85.7) | 243 (69.4) | 76 (63.9) |
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Ambulance | 97 (11.8) | 80 (22.9) | 25 (21.0) |
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Emergency physician vehicle transport | 21 (2.5) | 27 (7.7) | 18 (15.1) |
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| Drug-related factors | ||||||||||
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Number of medications reported by the ED physician per patient at time of ED visit, median (IQR) | 6 (3-10) | 5 (3-9) | 6 (3-9) | .23 | |||||
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Number of medications reported by the ED physician per patient at time of ED visit by first-level ATCd group, median (IQR) | |||||||||
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ATC A drugs (alimentary tract and metabolism) | 1 (0-2) | 1 (0-3) | 1 (0-2) | .74 | ||||
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ATC B (blood and blood forming agents) | 1 (0-1) | 1 (0-1) | 0 (0-1) | .18 | ||||
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ATC C (cardiovascular system) | 1 (0-3) | 1 (0-2) | 1 (0-2) | .88 | ||||
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ATC D (dermatologicals) | 0 (0-0) | 0 (0-0) | 0 (0-0) | .08 | ||||
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ATC G (genito urinary system and sex hormones) | 0 (0-0) | 0 (0-0) | 0 (0-0) | .34 | ||||
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ATC H (systemic hormonal preparations, excl. sex hormones and insulins) | 0 (0-0) | 0 (0-0) | 0 (0-0) | .57 | ||||
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ATC J (anti-infectives for systemic use) | 0 (0-0) | 0 (0-0) | 0 (0-0) | .004 | ||||
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ATC L (antineoplastic and immunomodulating agents) | 0 (0-0) | 0 (0-0) | 0 (0-0) | .60 | ||||
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ATC M (musculo-skeletal system) | 0 (0-0) | 0 (0-0) | 0 (0-0) | .04 | ||||
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ATC N (nervous system) | 1 (0-2) | 1 (0-2) | 1 (0-2) | .28 | ||||
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ATC P (antiparasitic products, insecticides, and repellents) | 0 (0-0) | 0 (0-0) | 0 (0-0) | .20 | ||||
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ATC R (respiratory system) | 0 (0-0) | 0 (0-0) | 0 (0-0) | .72 | ||||
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ATC S (sensory organs) | 0 (0-0) | 0 (0-0) | 0 (0-0) | .007 | ||||
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ATC V (various) | 0 (0-0) | 0 (0-0) | 0 (0-0) | .39 | ||||
| ED visit related factors | ||||||||||
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Specialty of the ED physician, n (%) | <.001 | ||||||||
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Emergency medicine | 107 (13.0) | 61 (17.4) | 19 (16.0) |
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Internal medicine | 569 (69.0) | 254 (72.6) | 77 (64.7) |
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Surgery | 148 (18.0) | 35 (10) | 21 (17.6) |
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Psychiatry | 0 (0) | 0 (0) | 2 (1.7) |
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Time of ED visit, n (%) | <.001 | ||||||||
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Morning | 340 (41.3) | 157 (44.9) | 81 (68.0) |
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Afternoon | 137 (16.6) | 33 (9.4) | 16 (13.4) |
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Evening | 260 (31.5) | 60 (17.1) | 1 (0.8) |
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Night | 87 (10.5) | 100 (28.6) | 21 (17.6) |
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| Medication reconciliation-related factors, n (%) | ||||||||||
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Availability of regional shared electronic medication record (yes) | 111 (13.5) | 80 (22.9) | 46 (38.6) | <.001 | |||||
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Electronic validation of the medication history by the ED physician (yes) | 155 (18.8) | 63 (18.0) | 31 (26.0) | .14 | |||||
| Outcome, n (%) | ||||||||||
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At least 1 clinically relevant medication discrepancy, (yes) | 287 (35) | 131 (37) | 58 (49) | .01 | |||||
aNot applicable.
bESI: Emergency Severity Index.
cED: emergency department.
dATC: Anatomical Therapeutic Chemical.