ICU Patients at Higher Risk of Misdiagnosis

A new study concludes that although misdiagnosis in the intensive care unit (ICU) may lead to as many annual deaths as breast cancer, this preventable problem does not receive enough attention. Researchers at the Johns Hopkins Armstrong Institute for Patient Safety and Quality found that 28 percent of patients had at least one hospital misdiagnosis at time of death, and in eight percent of those patients, the diagnosis error may have either caused or contributed to death.

“Our study shows that misdiagnosis is alarmingly common in the acute care setting,” said Bradford Winters, M.D., Ph.D., lead author and associate professor at the Johns Hopkins University School of Medicine. “To date, there’s been very little research to determine root causes or effective interventions.”

The study found that adult ICU patients are up to two times more likely to be the victim of fatal medical misdiagnosis than adult hospital patients overall. The most common diagnosis errors in the ICU involve heart attack, pulmonary embolism, pneumonia and aspergillosis. Together, these four conditions accounted for about one-third of all illnesses that doctors misdiagnose in ICU patients.

At the same time, less life-threatening patient safety risks have received greater attention. “It may be counterintuitive to think that the patients who are the most closely monitored and frequently tested are more commonly misdiagnosed, but the ICU is a very complex environment,” Winters said.

ICU misdiagnosis is preventable. This study indicates two frightening aspects of ICU care. First, 28 percent of ICU patients will die either directly or indirectly from a misdiagnosis. Second, an untold percentage of people will likely be gravely injured as the result of misdiagnoses in the ICU. Surviving family members of the deceased will suffer the pain of an untimely death, and those who are merely harmed by ICU misdiagnoses may experience the consequences for decades. These statistics call into question the purpose of an intensive care facility in the first place.

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