Discharging patients with missed diagnoses of acute cardiac ischemia is associated with increased mortality, influenced by race, sex, and atypical features.
Does failure to hospitalize patients with acute cardiac ischemia increase mortality, and what factors predict missed diagnoses?
Patients ≥30 years old presenting to the emergency department with symptoms suggestive of acute cardiac ischemia
Discharge from the emergency department (missed diagnosis/failure to hospitalize)
Hospitalization (correct diagnosis and admission)
Rate of missed diagnosis (failure to hospitalize) for acute myocardial infarction and unstable anginahard clinical
A small but clinically significant percentage of patients with acute cardiac ischemia are mistakenly discharged from the ED, which is associated with increased mortality and disproportionately affects women under 55 and nonwhite patients.
Tasa de eventos absoluta: 0% vs 0%
The percentage of patients who present to the emergency department with acute myocardial infarction or unstable angina who are not hospitalized is low, but the discharge of such patients is associated with increased mortality. Failure to hospitalize is related to race, sex, and the absence of typical features of cardiac ischemia. Continued efforts to reduce the number of missed diagnoses are warranted.
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Jennifer Pope
Institute of Cancer Research
Tom P. Aufderheide
Medical College of Wisconsin
Robin Ruthazer
Boston University
New England Journal of Medicine
Medical College of Wisconsin
Boston Medical Center
Providence College
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Pope et al. (Thu,) reported a other. Discharging patients with missed diagnoses of acute cardiac ischemia is associated with increased mortality, influenced by race, sex, and atypical features.
synapsesocial.com/papers/69898a06e91dc482c51abdcd — DOI: https://doi.org/10.1056/nejm200004203421603
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