The accuracy of a diagnosis of pneumonia in the emergency department
Background: Achieving a high degree of diagnostic accuracy of infections in the emergency department (ED) is crucial since a delay in diagnosis can lead to increased mortality, whereas overdiagnosis can lead to antibiotic overprescription. Limited data are available as to ED diagnostic accuracy of i...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2019-12-01
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| Series: | International Journal of Infectious Diseases |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971219303534 |
| _version_ | 1828482818807693312 |
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| author | Alaa Atamna Shachaf Shiber Muhammad Yassin Michael J. Drescher Jihad Bishara |
| author_facet | Alaa Atamna Shachaf Shiber Muhammad Yassin Michael J. Drescher Jihad Bishara |
| author_sort | Alaa Atamna |
| collection | DOAJ |
| description | Background: Achieving a high degree of diagnostic accuracy of infections in the emergency department (ED) is crucial since a delay in diagnosis can lead to increased mortality, whereas overdiagnosis can lead to antibiotic overprescription. Limited data are available as to ED diagnostic accuracy of infections. The aim of this study was to demonstrate the degree of discordance of an ED diagnosis of pneumonia in relation to an internal medicine ward’s discharge diagnosis of hospitalized adults. Methods: We reviewed the records of all adults hospitalized in internal wards from November 2017-January 2018 diagnosed with an acute infection by an ED physician. The primary outcome was the discordance degree of an ED pneumonia diagnosis compared to the internal ward discharge diagnosis. The influence comorbidities and clinical characteristics on the diagnostic discordance were also evaluated. Results: The study included 875 adults; 434 were admitted with an ED diagnosis of a specific infection. Pneumonia was the most frequent ED diagnosis (n = 195, 45%), of them, 56 (29%) were discordant diagnosis in the internal ward. Conclusion: Interpretation of chest X-rays with the assistance of a radiologist might help in reducing overdiagnosis and minimize antibiotic overprescription, thus improving the ED diagnostic accuracy of pneumonia. Keywords: Infection, Pneumonia, Emergency department, Diagnosis, Accuracy |
| first_indexed | 2024-12-11T08:22:44Z |
| format | Article |
| id | doaj.art-152e79a632014f9b82c367b9cb6729f6 |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-12-11T08:22:44Z |
| publishDate | 2019-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-152e79a632014f9b82c367b9cb6729f62022-12-22T01:14:37ZengElsevierInternational Journal of Infectious Diseases1201-97122019-12-01896265The accuracy of a diagnosis of pneumonia in the emergency departmentAlaa Atamna0Shachaf Shiber1Muhammad Yassin2Michael J. Drescher3Jihad Bishara4Infectious Disease Unit, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Corresponding author at: Infectious Disease Unit, Rabin Medical Center, Beilinson Hospital, Petah Tiqva, 49100, Israel.Emergency Department, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelInternal Medicine C, Rabin Medical Center, Hasharon Hospital, Petah Tikva, IsraelEmergency Department, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelInfectious Disease Unit, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelBackground: Achieving a high degree of diagnostic accuracy of infections in the emergency department (ED) is crucial since a delay in diagnosis can lead to increased mortality, whereas overdiagnosis can lead to antibiotic overprescription. Limited data are available as to ED diagnostic accuracy of infections. The aim of this study was to demonstrate the degree of discordance of an ED diagnosis of pneumonia in relation to an internal medicine ward’s discharge diagnosis of hospitalized adults. Methods: We reviewed the records of all adults hospitalized in internal wards from November 2017-January 2018 diagnosed with an acute infection by an ED physician. The primary outcome was the discordance degree of an ED pneumonia diagnosis compared to the internal ward discharge diagnosis. The influence comorbidities and clinical characteristics on the diagnostic discordance were also evaluated. Results: The study included 875 adults; 434 were admitted with an ED diagnosis of a specific infection. Pneumonia was the most frequent ED diagnosis (n = 195, 45%), of them, 56 (29%) were discordant diagnosis in the internal ward. Conclusion: Interpretation of chest X-rays with the assistance of a radiologist might help in reducing overdiagnosis and minimize antibiotic overprescription, thus improving the ED diagnostic accuracy of pneumonia. Keywords: Infection, Pneumonia, Emergency department, Diagnosis, Accuracyhttp://www.sciencedirect.com/science/article/pii/S1201971219303534 |
| spellingShingle | Alaa Atamna Shachaf Shiber Muhammad Yassin Michael J. Drescher Jihad Bishara The accuracy of a diagnosis of pneumonia in the emergency department International Journal of Infectious Diseases |
| title | The accuracy of a diagnosis of pneumonia in the emergency department |
| title_full | The accuracy of a diagnosis of pneumonia in the emergency department |
| title_fullStr | The accuracy of a diagnosis of pneumonia in the emergency department |
| title_full_unstemmed | The accuracy of a diagnosis of pneumonia in the emergency department |
| title_short | The accuracy of a diagnosis of pneumonia in the emergency department |
| title_sort | accuracy of a diagnosis of pneumonia in the emergency department |
| url | http://www.sciencedirect.com/science/article/pii/S1201971219303534 |
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