Missed Diagnoses in the ICU

Very sick patients often land in the intensive care unit of a hospital so they can be carefully monitored minute by minute by highly specialized health care providers. A study from Johns Hopkins now estimates that more than one fourth of such patients suffer diagnostic errors.
The researchers reviewed 31 studies in which more than 5,000 ICU patients were autopsied after they died. The autopsy results were compared to the diagnoses the patients had received while being treated in the hospital. Around 8 percent of the autopsies revealed undiagnosed conditions that contributed directly to the patients’ deaths. This could translate to more than 40,000 deaths annually from missed diagnoses.
The most frequent errors involved overlooking heart attacks, pulmonary embolisms, pneumonia and fungal infections. It is especially shocking to learn that patients in an ICU are twice as likely to suffer a fatal misdiagnosis as other hospital patients. This occurs despite intensive monitoring and supervision and points to the need for better ways to approach diagnosis in these extremely vulnerable patients.
[BMJ Quality & Safety, online July. 24, 2012]