Nearly 20% of Cleveland Clinic ICU Patients Were Misdiagnosed, Study Says
Cleveland Clinic researchers found misdiagnoses in almost 20% of ICU patients on whom autopsies were performed, according to a study published in this month's issue of the journal Chest and featured yesterday on ABC's World News Tonight with Peter Jennings. In a retrospective medical chart and autopsy report review, clinic researchers studied ICU data from 1994 and 1995. Of the 1,800 patients admitted during the study period, 401 died while at the hospital (22.3%). Of this group, the hospital performed autopsies on 91 patients and found that in 18 (19.8%) of the cases, diagnoses was different pre- and post-mortem. Further, in 44.4%, or eight, of the discordant cases, knowledge of the correct pre-term diagnosis would have altered treatment. The authors note that of the seven autopsied patients who had organ transplantation, three had discordant diagnoses, including two patients with disseminated fungal infection that was not diagnosed clinically (Tai et al, Chest, February 2001). World News Tonight reports that the most commonly overlooked medical problems were infections and blood clots in the lungs. Misdiagnoses happen "because health care now is very effective and very complicated," Lucian Leape, a medical errors expert with the Harvard School of Public Health, said. According to World News Tonight, "the Cleveland Clinic is an internationally renowned medical center with state-of-the-art diagnostic facilities. Other autopsy studies from other hospitals have found much higher rates of misdiagnosis" (McKenzie, World News Tonight, 2/15). The study is available at http://www.chestjournal.org/cgi/content/abstract/119/2/530.
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