Menopause is rarely coded in the emergency department: A real-world study of 413,414 visits by women aged 40-65 years (the MIMOSA study).
Only 0.79% of midlife women had menopause recorded in emergency department visits.
Menopause is rarely coded in the emergency department: A real-world study of 413,414 visits by women aged 40-65 years (the MIMOSA study).
To quantify how often menopause is captured by diagnostic coding among women aged 40 to 65 attending the emergency department with potentially menopause-related symptoms, to characterise their presentation, and to identify factors associated with coding, early reattendance (within 72 h) and short-stay admission (under 48 h).
The incidence cohort (each woman's first recorded visit) was the primary unit of analysis, with the visit level used for sensitivity analysis; cardiometabolic conditions were treated as covariates.
menopause is almost never coded despite matching symptoms, a big missed opportunity
We analysed 413,414 visits by 97,105 women (median age 45 years at entry).
Negation handling substantially lowered text-based symptom frequencies (chest pain 20.5% to 5.6%; dyspnoea 30.3% to 6.8%).
Among nonspecific cardiorespiratory presentations, only 1.5% of 72-h reattendances revealed serious cardiovascular disease.
In the incidence cohort, reattendance within 72 h occurred in 3.7% of women and short-stay admission in 0.6%; these analyses were exploratory and showed limited discrimination.
Menopause-related diagnostic coding is uncommon in the emergency department among midlife women with compatible symptoms, and it depends more on the presence of other gynaecological codes than on the clinical picture.
Because coding is not equivalent to clinical recognition, the findings indicate low menopause-related coding and potential missed opportunities for recognition.