Characteristics of discrepancies between clinical and autopsy diagnoses in the intensive care unit: a 5-year review

Silfvast, Tom; Takkunen, O.; Kolho, Elina; Andersson, Leif C.; Rosenberg, P. H.

doi:10.1007/s00134-002-1576-z

Cited by 57 publications

(44 citation statements)

References 8 publications

(12 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These results are comparable with our previous study [13] where the discrepancy rate was 23%. Other studies have reported major diagnostic discrepancies in 5-40% of all hospitalised patients and in 7-32% of ICU patients [7,10,11,15,31,43,46,48,50]. These differences among studies may be explained not only by different ICU populations but also by differences in the indications for autopsy.…”

Section: Discussionmentioning

confidence: 97%

Comparison of clinical and post-mortem findings in intensive care unit patients

Maris

Martin

Créteur³

et al. 2007

Virchows Arch

View full text Add to dashboard Cite

The autopsy has long been regarded as an important tool for clinical confrontation, education and quality assurance. The aims of this study were to examine the correlation between the clinical diagnosis and autopsy findings in adult patients who died in an intensive care unit (ICU) and to identify the types of errors in diagnosis to improve quality of care. Autopsies from 289 patients who died in the ICU during a 2-year period were studied. Post-mortem examination revealed unexpected findings in 61 patients (21%) including malignancy, pulmonary embolism, aspergillosis, myocardial or mesenteric infarction and unsuspected bacterial, viral or fungal infection. These unexpected findings were classified as Goldman class I errors in 17 (6%), class II in 38 (13%) and class III in six (2%) cases. Although the incidence of unexpected findings with clinical significance was low, post-mortem examination remains a valuable source of pertinent information that may improve the management of ICU patients.

show abstract

Section: Discussionmentioning

confidence: 97%

Comparison of clinical and post-mortem findings in intensive care unit patients

Maris

Martin

Créteur³

et al. 2007

Virchows Arch

View full text Add to dashboard Cite

show abstract

“…This diversity may be due to difference in design of study, duration of study, type of underlying or immunosuppressive conditions and diagnosis methods. In addition, some authors suggested that invasive fungal infections are among the most commonly missed diagnoses in ICU patients (7,28,34).…”

Section: Discussionmentioning

confidence: 99%

Invasive Aspergillosis in Intensive Care Unit Patients in Iran

Hedayati

Khodavaisy

Amini

et al. 2013

Acta Med. (Hradec Kralove, Czech Repub.)

View full text Add to dashboard Cite

Summary:We assessed the intensive care unit (ICU) patients for Invasive aspergillosis (IA) with culture and non-culture based diagnostic methods from Iran. Thirty-six ICU patients with underlying predisposing conditions for IA were enrolled in the study. Sixty eight Bronchoalveolar lavage (BAL) samples were collected by bronchoscope twice a weekly. BAL samples were analyzed by microscopic examination, fungal culture and galactomannan (GM) detection. The Platelia Aspergillus GM EIA was used to quantify GM indices. Samples with a BAL GM index ≥1 were considered as positive for GM. Patients were classified as having probable or possible IA. Out of 36 suspected patients to IA, 36.1% of cases showed IA which were categorized as: 4 cases of possible IA and 9 of probable IA. 76.2% of BAL samples were positive for GM. From 13 patients with IA, 11 (84.6%) had at least one positive BAL GM index. Of these patients, 9 (81.8%) showed probable IA. The main underlying predisposing conditions were neutropenia (53.8%) and COPD (30.8%). Our study has indicated that COPD must be considered as one of the main predisposing condition for occurrence of aspergillosis in ICU patients. Our data have also revealed that GM detection in BAL samples play a significant role to IA diagnosis.

show abstract

“…Currently, autopsy can provide additional information in more than one third of pediatric deaths, 40 including previously undiagnosed findings, complications, and unsuspected contributors to death. [41][42][43] This information may be of importance to parents and other relatives in future family planning and to physicians in helping to educate and improve the quality of care in medicine. Providing this information can help parents to make an informed decision when they are asked about permission for postmortem examination.…”

Section: Postmortem Examinations and Tissue And Organ Donationmentioning

confidence: 99%

Death of a Child in the Emergency Department

Knapp¹

2005

Pediatrics

View full text Add to dashboard Cite

ABSTRACT. Of the estimated 40 000 American children <14 years old who die each year, approximately 20% die or are pronounced dead in outpatient sites, primarily the emergency department (ED). The ED is distinguishable from other sites at which children die, because the death is often sudden, unexpected, and without a previously established physician-patient care relationship. Despite these difficult circumstances and potentially limited professional experience with the death of a child, the emergency physician must be prepared to respond to the emotional, cultural, procedural, and legal issues that are an inevitable part of caring for ill and injured children who die. All of this must be accomplished while supporting a grieving family. There is also a responsibility to inform the child's pediatrician of the death, who in turn also must be prepared to counsel and support bereaved families. The American Academy of Pediatrics and American College of Emergency Physicians collaborated on the joint policy statement, "Death of a Child in the Emergency Department," agreeing on recommendations on the principles of care after the death of a child in the ED. This technical report provides the background information, consensus opinion, and evidence, where available, used to support the recommendations found in the policy statement. Important among these are the pediatrician's role as an advocate to advise in the formulation of ED policy and procedure that facilitate identification and management of medical examiners' cases, identification and reporting of child maltreatment, requests for postmortem examinations, and procurement of organ donations.

show abstract

Characteristics of discrepancies between clinical and autopsy diagnoses in the intensive care unit: a 5-year review

Abstract: Despite the availability of advanced diagnostic facilities, especially infectious complications seem to remain undiagnosed. Autopsy is a valuable tool with which to monitor diagnostic accuracy in these patients.

Cited by 57 publications

References 8 publications

Comparison of clinical and post-mortem findings in intensive care unit patients

Comparison of clinical and post-mortem findings in intensive care unit patients

Invasive Aspergillosis in Intensive Care Unit Patients in Iran

Death of a Child in the Emergency Department

Contact Info

Product

Resources

About