Analysis of discrepancies between clinical and autopsy diagnoses in 188 cases / 中华病理学杂志
Chinese Journal of Pathology
; (12): 366-369, 2009.
Article
in Zh
| WPRIM
| ID: wpr-249111
Responsible library:
WPRO
ABSTRACT
<p><b>OBJECTIVE</b>To analyze the discrepancies between clinical and autopsy diagnoses in hospitals of different grades and with respect to duration of hospitalization.</p><p><b>METHODS</b>A total of 188 autopsy cases collected from hospitals of different grades were retrospectively reviewed and the discrepancies between clinical and autopsy diagnoses were analyzed.</p><p><b>RESULTS</b>The overall rate of misdiagnosis was 48.9% (92/188). The misdiagnosis rate in grade I hospitals (75.8%, 25/33) was significantly higher than that in grade III (39.6%, 38/96; chi(2) = 12.861, P = 0.000) and grade II hospitals (49.2%, 29/59; chi(2) = 6.179, P = 0.016 ). The misdiagnosis rate of patients beyond 24 hours of admission was lower than that admitted within 24 hours (chi(2) = 20.991, P = 0.000). The overall rate of missed diagnosis was 34.6% (65/188). The rate of missed diagnosis in grade I hospitals was remarkably higher than that of the grade III hospitals (chi(2) = 8.241, P = 0.006). There was no difference between grades I and III hospitals on the rate of missed diagnosis within 24 hours of admission, however, this rate was lower in grade III hospitals in comparing with that of grade I hospitals in patients admitted beyond 24 hours (chi(2) = 5.181, P = 0.047). The distribution of disease entities commonly encountered in patients of both misdiagnosis and missed diagnosis were heart problems, infections, arterial diseases and pulmonary embolism.</p><p><b>CONCLUSIONS</b>The rate of discrepancies between clinical and autopsy diagnoses is relatively high. The misdiagnosis and missed diagnosis rate in grade I hospitals was significantly higher than that in grade III hospitals and was closely related with the duration of hospitalization. Autopsy study thus still remains an important measure in clinical audit.</p>
Full text:
1
Index:
WPRIM
Main subject:
Aortic Aneurysm
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Pathology
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Pulmonary Embolism
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Autopsy
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Retrospective Studies
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Cause of Death
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Diagnosis
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Diagnostic Errors
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Hospitals, Community
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Hospitals, General
Type of study:
Diagnostic_studies
/
Observational_studies
Limits:
Adult
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Aged
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Female
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Humans
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Male
Language:
Zh
Journal:
Chinese Journal of Pathology
Year:
2009
Type:
Article