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Missed Diagnoses in ICU Often Have Deadly Results: Review
Date:8/28/2012

TUESDAY, Aug. 28 (HealthDay News) -- Misdiagnosis causes or contributes to as many as 40,500 patient deaths in intensive care units in U.S. hospitals each year, which is about the same number of deaths caused each year by breast cancer.

That's the finding of a team of researchers who reviewed 31 studies that provided details about more than 5,800 autopsies conducted to detect diagnostic errors in adult intensive care unit (ICU) patients.

The investigators found that 28 percent of those ICU patients -- more than one in four -- had at least one missed diagnosis at death. In 8 percent of the patients, the diagnostic error was serious enough that it may have caused or directly contributed to the patients' deaths and, if known, would have led to changes in their treatment.

Infections and vascular conditions, such as heart attack and stroke, accounted for more than three-quarters of the fatal diagnostic errors, according to the researchers at the Johns Hopkins Armstrong Institute for Patient Safety and Quality.

The conditions most commonly missed by medical staff included heart attack; pulmonary embolism, typically a blood clot in the lungs; pneumonia; and aspergillosis, a fungal infection that most commonly affects people with a weakened immune system. Together, these four conditions accounted for about one-third of all illnesses that doctors failed to detect in ICU patients.

The study was released online in advance of print publication in the journal BMJ Quality & Safety.

Despite the fact that diagnostic errors in the ICU claim so many lives a year, they are an underappreciated cause of preventable patient harm, the study authors noted in a Johns Hopkins news release.

"Our study shows that misdiagnosis is alarmingly common in the acute care setting," lead author Dr. Bradford Winters, an associate professor of anesthesiology and critical care medicine and neurology and surgery in the Johns H
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