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?
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.
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.
Pope et al. (2000) studied this question. Discharging patients with missed diagnoses of acute cardiac ischemia is associated with increased mortality, influenced by race, sex, and atypical features.