ArticleCritical care (London, England)2019
In-hospital mortality associated with the misdiagnosis or unidentified site of infection at admission.
Article in Critical care (London, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
36 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Sepsis prediction, early detection, and identification using clinical text for machine learning: a systematic review.Journal of the American Medical Informatics Association : JAMIA · 2022Pooled it
- Article
- Sequential Application of Time-Stratified Demographic, Vital, Clinical-Laboratory, and Microbiology Variables for Accurate and Rapid Identification of Sepsis.Diseases (Basel, Switzerland) · 2026Article
- Observational
- Comparing clinical assessments of pneumonia to bronchoalveolar lavage results in critically ill patients with suspected pneumonia.Annals of the American Thoracic Society · 2026Observational
- Vasopressor Dosing Trajectories in Septic Shock According to Initial Antimicrobial Susceptibility and Infection Source Concordance: A Retrospective Observational Study.Medical sciences (Basel, Switzerland) · 2026Observational
- The Effect of Sepsis Recognition on Telemedicine Use in Rural Emergency Department Sepsis Treatment.Telemedicine journal and e-health : the official journal of the American Telemedicine Association · 2025Article
- Qualitative Study of the Context of Health Information Technology in Sepsis Care Transitions: Facilitators, Barriers, and Strategies for Improvement.Journal of the American Medical Directors Association · 2025Article
- Enhancing infectious intestinal disease diagnosis through metagenomic and metatranscriptomic sequencing of 1000 human diarrhoeal samples.Genome medicine · 2025Article
- A comprehensive evaluation of plasma metagenomics sequencing for the diagnosis of suspected infection in pediatric patients with hematologic diseases.Frontiers in cellular and infection microbiology · 2025Article
- Diagnosis, treatment, and monitoring of cytomegalovirus pneumonia in a hematopoietic stem cell transplantation child.Frontiers in cellular and infection microbiology · 2025Article
- Epidemiology and outcomes of septic shock in Thai children: a nationwide retrospective study from 2015 to 2022.Critical care (London, England) · 2024Article
- Infectious Foci, Comorbidities and Its Influence on the Outcomes of Septic Critically Ill Patients.Microorganisms · 2024Article
- Accuracy Evaluation of GPT-Assisted Differential Diagnosis in Emergency Department.Diagnostics (Basel, Switzerland) · 2024Article
- Influence of initial misdiagnosis on mortality in patients with bacteraemia: propensity score matching and propensity score weighting analyses.BMC infectious diseases · 2024Article
- Identifying acute illness phenotypes via deep temporal interpolation and clustering network on physiologic signatures.Scientific reports · 2024Article
- Article
- Diagnostic Accuracy of Point-of-Care Gram Stains in Obstructive Pyelonephritis due to Ureteral Stones.Open forum infectious diseases · 2024Article
- Association of Diagnostic Discrepancy with Length of Stay and Mortality in Congestive Heart Failure Patients Admitted to the Emergency Department.AMIA Joint Summits on Translational Science proceedings. AMIA Joint Summits on Translational Science · 2024Article
- Utility of Metagenomic Next-Generation Sequencing for Diagnosis of Infectious Diseases in Critically Ill Immunocompromised Pediatric Patients.Infection and drug resistance · 2024Article
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21 authors.
Funding
Abstract
backgroundRapid detection, early resuscitation, and appropriate antibiotic use are crucial for sepsis care. Accurate identification of the site of infection may facilitate a timely provision of appropriate care. We aimed to investigate the relationship between misdiagnosis of the site of infection at initial examination and in-hospital mortality.
methodsThis was a secondary-multicenter prospective cohort study involving 37 emergency departments. Consecutive adult patients with infection from December 2017 to February 2018 were included. Misdiagnosis of the site of infection was defined as a discrepancy between the suspected site of infection at initial examination and that at final diagnosis, including those infections remaining unidentified during hospital admission, whereas correct diagnosis was defined as site concordance. In-hospital mortality was compared between those misdiagnosed and those correctly diagnosed.
resultsOf 974 patients included in the analysis, 11.6% were misdiagnosed. Patients diagnosed with lung, intra-abdominal, urinary, soft tissue, and CNS infection at the initial examination, 4.2%, 3.8%, 13.6%, 10.9%, and 58.3% respectively, turned out to have an infection at a different site. In-hospital mortality occurred in 15%. In both generalized estimating equation (GEE) and propensity score-matched models, misdiagnosed patients exhibited higher mortality despite adjustment for patient background, site infection, and severity. The adjusted odds ratios (misdiagnosis vs. correct diagnosis) for in-hospital mortality were 2.66 (95% CI, 1.45-4.89) in the GEE model and 3.03 (95% CI, 1.24-7.38) in the propensity score-matched model. The difference in the absolute risk in the GEE model was 0.11 (0.04-0.18).
conclusionsAmong patients with infection, misdiagnosed site of infection is associated with a > 10% increase in in-hospital mortality.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.