28% of ICU patients have missed diagnosis

More than one in four ICU patients had at least one missed diagnosis at death, according to a Johns Hopkins study of acute care patients. That means as many as 40,500 adult ICU patients in the country may die with misdiagnosis every year, the study states.

In reviewing more than 5,800 autopsies, researchers found that 28 percent of patients had a missed diagnosis, such as heart attack, pulmonary embolism, artery blockage in the lungs, pneumonia and aspergillosis (fungal infection). Even more, 8 percent of the diagnostic errors could have contributed or directly caused the patient's death.

Researchers did adjust their numbers, accounting for the fact that autopsies are more commonly performed on complex patients.

Still, the study suggests that misdiagnosis in the acute care setting is "alarmingly common," lead study author Bradford Winters, associate professor of anesthesiology and critical care medicine and neurology and surgery in the Johns Hopkins University School of Medicine, said in a statement yesterday.

Even though two-thirds of misdiagnosed cases may not have contributed to death, study authors note that the errors could lead to longer hospital stays, unnecessary surgery and poorer quality of life for the patients.

"The bottom line is that these were misdiagnoses made by the ICU staff," Winters told HealthLeaders Media.

Winters suggested hospitals consider employing intensivists to monitor their ICUs, as well as improving nurse-to-patient ratios.

For more information:
- read the research announcement
- check out the study abstract
- read the HealthLeaders Media article

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