ArticleSao Paulo medical journal = Revista paulista de medicina
Diagnostic discrepancies between emergency department admissions and hospital discharges among older adults: secondary analysis on a population-based survey.
Article in Sao Paulo medical journal = Revista paulista de medicina. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 16 citations in OpenAlex.
- Observational
- Diagnostic Relabelling and Concordance in Emergency Departments: A Comment on Mattoo et al. Study.Archives of academic emergency medicine · 2025Article
- Agreement Between Emergency Department Admission and Hospital Discharge Diagnoses; A Retrospective Observational Study.Archives of academic emergency medicine · 2025Article
- A Clinical Evaluation of Cardiovascular Emergencies: A Comparison of Responses from ChatGPT, Emergency Physicians, and Cardiologists.Diagnostics (Basel, Switzerland) · 2024Article
- Minimizing the Risk of Diagnostic Errors in Acute Care for Older Adults: An Interdisciplinary Patient Safety Challenge.Healthcare (Basel, Switzerland) · 2024Article
- Accuracy Evaluation of GPT-Assisted Differential Diagnosis in Emergency Department.Diagnostics (Basel, Switzerland) · 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
- Mortality by Admission Diagnosis in Children 1-60 Months of Age Admitted to a Tertiary Care Government Hospital in Malawi.The American journal of tropical medicine and hygiene · 2023Article
- Patient recalls associated with resident-to-attending radiology report discrepancies: predictive factors for risky discrepancies.Insights into imaging · 2022Article
- Incidence of Diagnostic Errors Among Unexpectedly Hospitalized Patients Using an Automated Medical History-Taking System With a Differential Diagnosis Generator: Retrospective Observational Study.JMIR medical informatics · 2022Article
Corrections and comments
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Authors and funding
2 authors at 1 institution in 2 countries.
Funding
Abstract
backgroundOlder adults frequently experience nonspecific clinical features. However, there is limited evidence on how often admission diagnoses for hospitalized older patients are incorrect, potentially leading to treatment delays.
objectivesTo determine the consistency between hospital admission and discharge diagnoses, and identify factors associated with diagnostic discrepancies in older adults. DESIGN AND
settingPopulation-based cohort study in the United States. We included adults aged ≥ 18 years who were admitted from emergency departments (EDs) to hospitals, identified using the 2005-2010 National Hospital Ambulatory Medical Survey, a nationally representative survey.
methodsThree admission diagnoses and the principal discharge diagnosis were captured and classified as discrepant if they involved considerably different conditions within the same organ system, or different organ systems altogether.
resultsEach year, 12 million adults were hospitalized following ED visits in the United States; 45% were aged ≥ 65 years. These patients' mean age was 79 years and 58% were women. Diagnostic discrepancies between admission and discharge were more common among adults ≥ 65 years (12.5 versus 8.3%; P < 0.001). Certain admission diagnoses had particularly high rates of diagnostic discrepancies: 26-27% of patients presenting with mental disorders or with endocrine and metabolic diseases had substantial diagnostic discrepancies between admission and discharge. Substantial diagnostic discrepancy was independently associated with longer hospitalization and higher in-hospital mortality.
conclusionOne out of eight older adults hospitalized from EDs was discharged with a principal diagnosis differing considerably from the admission diagnosis. Given that missed or delayed diagnoses are a critical safety problem, clinicians should be vigilant and frequently cogitate alternative diagnostic possibilities.
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