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Open Access Original research

Structured classification for ED presenting complaints – from free text field-based approach to ICPC-2 ED application

Tomi Malmström1*, Olli Huuskonen2, Paulus Torkki1 and Raija Malmström3

Author Affiliations

1 Institute of Healthcare Engineering and Management, Department of Industrial Engineering and Management, Aalto University, Otaniementie 17, 00076, Aalto, Finland

2 Jorvi Hospital, Division of Emergency Care, Meilahti Hospital, Helsinki University Hospital District, Helsinki, Finland

3 Department of Medicine, Division of Emergency Care, Meilahti Hospital, Helsinki University Hospital District, Helsinki, Finland

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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2012, 20:76  doi:10.1186/1757-7241-20-76

Published: 24 November 2012



Although there is a major need to record and analyse presenting complaints in emergency departments (EDs), no international standard exists. The aim of the present study was to produce structured complaint classification suitable for ED use and to implement it in practice. The structured classification evolved from a study of free text fields and ICPC-2 classification.


Presenting complaints in a free text field of ED admissions during a one-year period (n=40610) were analyzed and summarized to 70 presenting complaint groups. The results were compared to ICPC-2 based complaints collected in another ED. An expert panel reviewed the results and produced an ED application of ICPC-2 classification. This study implemented the new classification into an ED.


The presenting complaints summarized from free text fields and those from ICPC-2 categories were remarkably similar. However, the ICPC-2 classification was too broad for ED; an adapted version was needed. The newly developed classification includes 89 presenting complaints and ED staff found it easy to use.


ICPC-2 classification can be adapted for ED use. The authors suggest a list of 89 presenting complaints for use in EDs adult patients.