Studies: Pneumonia is misdiagnosed on patient readmissions

Oct 22, 2010

Patients were misdiagnosed with pneumonia at an alarming rate when they were readmitted to the hospital shortly after a previous hospitalization for the same illness, according to two Henry Ford Hospital companion studies.

Researchers say the misdiagnoses led to overuse of antibiotics and increased . Pneumonia ranks second to congestive as the reason for readmission within 30 days of a previous hospitalization.

Led by Henry Ford Infectious Diseases physicians Hiren Pokharna, M.D., and Norman Markowitz, M.D., researchers found that:

  • 72 percent of patients were misdiagnosed with pneumonia upon readmission to the same hospital.
  • African-Americans were twice more likely than Caucasians to be misdiagnosed with pneumonia.
  • Patients who smoke or have lung disease were likely to be misdiagnosed with pneumonia.
  • 72 percent of the misdiagnoses occurred in the Emergency Department.
  • Fewer than 33 percent of patients had any outpatient follow-up care prior to their readmission.
Results of the two companion studies will be presented Friday at the 48th annual meeting of the Society of America Oct. 21-24 in Vancouver.

"These studies show that we need to increase awareness among physicians about using the diagnostic standards and criteria set forth in the Centers for Disease Control and Prevention's National Healthcare Safety Network for diagnosing pneumonia at the time of readmission," says Dr. Pokharna, a fellow at Henry Ford and the lead author of the companion studies.

"This also points to the importance of using X-ray for ruling out pneumonia. And once pneumonia is ruled out, the antibiotics can be discontinued."

In seeking to explain the difficulty of diagnosing pneumonia and high prevalence of misdiagnoses, Henry Ford researchers examined medical records of 127 patients diagnosed with pneumonia between December 2008 and December 2009 and readmitted within 30 days of a previous hospitalization.

Researchers found that 92 of the 127 patients were misdiagnosed with health care associated pneumonia using CDC/National Healthcare Safety Network criteria. Health care associated pneumonia is a newly recognized form of in patients who had recent close contact with a health care system, either through a hospital, outpatient dialysis center, nursing home or long-term care facility. The classification was added with the shift from hospital-based care to home-based care.

Researchers cited several reasons for the misdiagnoses, including pre-existing lung disease and abnormalities on chest X-rays.

Explore further: Flu season, early again, hitting hard in South and Midwest

add to favorites email to friend print save as pdf

Related Stories

Lower-cost hospital care is not always lower in quality

Feb 22, 2010

The costs that hospitals incur in treating patients vary widely and do not appear to be strongly associated either with the quality of care patients receive or their risk of dying within 30 days, according to a report in ...

Flu vaccine may not protect seniors well

Aug 01, 2008

A Group Health study in the August 2 issue of The Lancet adds fuel to the growing controversy over how well the flu vaccine protects the elderly.

Statins associated with lower risk of death from pneumonia

Oct 27, 2008

Individuals who take cholesterol-lowering statins before being hospitalized with pneumonia appear less likely to die within 90 days afterward, according to a report in the October 27 issue of Archives of Internal Medicine, one of ...

Recommended for you

Liberia holds Senate vote amid Ebola fears

2 hours ago

Health workers manned polling stations across Liberia on Saturday as voters cast their ballots in a twice-delayed Senate vote that has been criticized for its potential to spread the deadly Ebola disease.

Evidence-based recs issued for systemic care in psoriasis

22 hours ago

(HealthDay)—For appropriately selected patients with psoriasis, combining biologics with other systemic treatments, including phototherapy, oral medications, or other biologic, may result in greater efficacy ...

Bacteria in caramel apples kills at least four in US

23 hours ago

A listeria outbreak believed to originate from commercially packaged caramel apples has killed at least four people in the United States and sickened 28 people since November, officials said Friday.

Steroid-based treatment may answer needs of pediatric EoE patients

23 hours ago

A new formulation of oral budesonide suspension, a steroid-based treatment, is safe and effective in treating pediatric patients with eosinophilic esophagitis (EoE), according to a new study in Clinical Gastroenterology and Hepatology, the official clinical practice journal ...

Discovery of genes that predispose a severe form of COPD

Dec 19, 2014

A study by Ramcés Falfán-Valencia, researcher at the National Institute of Respiratory Diseases (INER), found that the mestizo Mexican population has a number of variations in certain genes that predispose ...

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.