Diagnostic Errors In The ICU May Lead The Death
According to a review by the Johns Hopkins University School of Medicine, more than 40,000 U.S. adults may be dying while in a hospital intensive care unit due to misdiagnosis of their illness by their attending medical team. The study was to determine if fatal misdiagnoses were more common in ICU than in the general hospital population, and if they involved more infections or vascular events such as heart attacks.
The researchers examined more than 30 studies that sourced autopsies to detect undiagnosed medical issues leading to death in adult ICU patients More than one-in-four patients – some 28 percent – were found to have one or more missed diagnoses at death. Additionally, 8 percent of the patients had a diagnostic error found to be serious enough to either have caused or directly contributed to his or her death. . They determined that the misdiagnoses made by medical staff also included care meant to help an incorrectly identified condition. The lead author of the paper, Bradford Winters, MD, is Associate Professor of Anesthesiology and Critical Care Medicine at Johns Hopkins. He stated that he hoped the article would be a wake up call to medical professionals and patients alike.
The researchers stated that autopsies helped identify, in retrospect, the mistakes made and cause of death, and their study highlights a need to develop better treatment to reduce diagnostic errors. Common medical errors included missing that a patient had pneumonia or a heart attack, like the case of a patient presenting with symptoms that were treated as a blood clot in the lung, but was later found, upon autopsy, to have been a heart attack. In another case, the medical team missing a diagnosis of a serious fungal infection, one serious enough to take down a damaged immune system. Medical conditions most commonly missed, besides heart attack, was pneumonia and pulmonary embolism.
According to Dr. Winter, lowering the rate of inaccurate diagnoses may require equipment upgrades and improvements to medical technology, including improved imaging and blood tests. However, what hospitals can do now, says Dr. Winters, is to reduce the amount of distractions, follow care checklists, which may include if/then care steps, and ensure that the standard ICU nurse-to-patient ratio to 1-to1.
The 5,863 autopsies listed ion the 31 reports included those not just in the U.S., but internationally, including Brazil, France, Germany, and Slovenia. The studies of the autopsies that were performed on U.S. patients, researchers estimated that between 22,600 and 40,500 of the dead may have died due to a missed diagnosis – as many deaths each year as occur in the U.S. due to breast cancer.