ArticleBMJ open2024
Clinical characteristics and diagnostic accuracy of preliminary diagnoses in adults with infections in Danish emergency departments: a multicentre combined cross-sectional and diagnostic study.
Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 6 papers.
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The trial behind it
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.
A Descriptive Study of Patients Suspected With Infection in the Emergency Department, With a Special Focus on Infection With Unknown Origin.
Clinical Characteristics of Acutely Hospitalized Adults With Acute Pyelonephritis in the Emergency Department: A Cross-sectional Study
Clinical Characteristics of Hospitalized Adults With Community-acquired- Pneumonia at the Emergency Department: A Cross-sectional Study
Who cites it
6 citing papers in PubMed.
- Laboratory Markers Associated with Deep Neck Infection in Emergency Department Patients with Throat or Neck Symptoms.Diagnostics (Basel, Switzerland) · 2026Article
- Interobserver Agreement for Classifying Infections in Emergency Department Patients Using Modified Centers for Disease Control and Prevention Criteria.Open forum infectious diseases · 2026Article
- Performance of a clinical decision-support tool on empirical antibiotic treatment in the emergency department: a retrospective study.JAC-antimicrobial resistance · 2026Article
- Antimicrobial Resistance: A Bibliometric Review of Patient Health, Mechanisms, and Therapeutic Strategies.Pathogens (Basel, Switzerland) · 2026Review
- AI-based clinical prediction model for early infectious disease classification in the emergency department.Frontiers in artificial intelligence · 2026Article
- Evaluation of diagnostic accuracy using routine laboratory parameters.Bioinformation · 2026Article
Corrections and comments
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Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveRapid and accurate infection diagnosis is a prerequisite for appropriate antibiotic prescriptions in an ED. Accurately diagnosing acute infections can be difficult due to nonspecific symptoms and limitations of diagnostic testing. The accuracy of preliminary diagnoses, established on the initial clinical assessment, depends on a physician's skills and knowledge. It has been scarcely studied, and knowledge of how infected patients present at EDs today is needed to improve it. Based on expert reference diagnoses and a current ED population, this study aimed to characterise adults presenting at EDs with suspected infection to distinguish between infections and non-infections and to investigate the accuracy of the preliminary infection diagnoses.
designThis study was multicentre with a design that combined a cross-sectional study and a diagnostic study with a prospective enrolment.
settingMulticenter study including EDs at three Danish hospitals.
participantsAdults admitted with a preliminary diagnosis of an infectious disease. OUTCOME MEASURES: Data were collected from medical records and participant interviews. The primary outcome was the reference diagnosis made by two medical experts on chart review. Univariate logistic regression analysis was performed to identify factors associated with infectious diseases.
resultsWe included 954 patients initially suspected of having an infection, with 81% later having an infectious disease confirmed by experts. Parameters correlating to infection were fever, feeling unwell, male sex, high C-reactive protein, symptoms onset within 3 days, high heart rate, low oxygen saturation and abnormal values of neutrophilocytes and leucocytes. The three main conditions were community-acquired pneumonia (CAP) (34%), urinary tract infection (UTI) with systemic symptoms (21%) and cellulitis (10%). The sensitivity of the physician's preliminary infection diagnoses was 87% for CAP, 74% for UTI and 77% for other infections.
conclusionsFour out of five patients with a preliminary infection diagnosis, established on initial clinical assessment, were ultimately confirmed to have an infectious disease. The main infections included CAP, UTI with systemic symptoms and cellulitis. Physicians' preliminary infection diagnoses were moderately in accordance with the reference diagnoses. TRIAL REGISTRATION NUMBER: NCT04661085, NCT04681963, NCT04667195.
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