Discrepancias entre el diagnóstico clínico y el anatomopatológico en un Servicio de Cuidados Intensivos Polivalente

Iglesias, Martin; Tello, Luis; Olsina, S Fernández; García-Fontgivell, Joan Francesc; Vilàs, S Blázquez; Rubio, S Alonso; Santos, E Díaz; Calvera, JJ Sirvent; Rello, Jordi

doi:10.1016/s0210-5691(06)74481-3

Cited by 7 publications

(2 citation statements)

References 25 publications

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“…All these conditions can be deadly if not correctly diagnosed and managed appropriately. Indeed, the most common errors with therapeutic repercussion in relation to clinical diagnosis and necropsy studies are bacterial infections and cardiovascular diseases [23,24]. Data suggest that as many The values of sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV), positive likelihood ratio (LHR+) and negative likelihood ratio (LHR-) were calculated for the identification of infected patients.…”

Section: Introductionmentioning

confidence: 99%

“…All these conditions can be deadly if not correctly diagnosed and managed appropriately. Indeed, the most common errors with therapeutic repercussion in relation to clinical diagnosis and necropsy studies are bacterial infections and cardiovascular diseases [ 23 , 24 ]. Data suggest that as many as 40,500 adult patients in Intensive Care Units (ICU) in the United States may die annually due to misdiagnosis [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

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Monocyte distribution width (MDW) as an infection indicator in severe patients attending in the Emergency Department: a pilot study

Encabo¹,

Hernández-Álvarez²,

Oteo³

et al. 2023

Rev Esp Quimioter

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Background. The aim of the present study was to evaluate the diagnostic performance of monocyte distribution width (MDW) as a biomarker for sepsis diagnosis in severe patients attended in the Emergency Department for different conditions and not only infections. Methods. We performed an observational study in a consecutive prospective cohort including severe patients attending the Emergency Department with different conditions. MDW and other biomarkers were determined from samples obtained during the first care of patients. The diagnostic performance of the different biomarkers was determined based on the final diagnosis at patient discharge. Results. One hundred two patients, with a mean age of 76.7 (SD 16.5) years were included, 53 being (51.9%) male. Among the patients included, 65 (63.7%) had an infectious disease while the remaining had other different conditions. A MDW cut-off of 20.115 provided the best accuracy to identify infected patients, with a sensitivity of 89.2 (95% CI 79.4-94.7), a specificity of 89.2 (95% CI 75.3-95.7), a positive predictive value of 93.5 (95% CI 84.6-97.5), a negative predictive value of 82.5% (95% CI 68.0-91.3), a positive likelihood ratio of 8.25 (3.26-20.91), and a negative likelihood ratio of 0.12 (0.06-0.24). The area under the receiver operating characteristic curve for infection according to MDW was 0.943 (95% CI 0.897-0.989; p<0.001). Conclusions. A MDW > 20.115 may be associated with infection and could help to distinguish between infected and non-infected patients in severe patients. These results must be confirmed in new studies due to the limited patient sample included.

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Section: Introductionmentioning

confidence: 99%

“…All these conditions can be deadly if not correctly diagnosed and managed appropriately. Indeed, the most common errors with therapeutic repercussion in relation to clinical diagnosis and necropsy studies are bacterial infections and cardiovascular diseases [ 23 , 24 ]. Data suggest that as many as 40,500 adult patients in Intensive Care Units (ICU) in the United States may die annually due to misdiagnosis [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

Monocyte distribution width (MDW) as an infection indicator in severe patients attending in the Emergency Department: a pilot study

Encabo¹,

Hernández-Álvarez²,

Oteo³

et al. 2023

Rev Esp Quimioter

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Discrepancias entre el diagnóstico clínico y el diagnóstico anatomopatológico en la mortalidad temprana del trasplante pulmonar

et al. 2009

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Perspectivas futuras para la autopsia clínica en los pacientes procedentes de la unidad de cuidados críticos y urgencias

et al. 2009

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Discrepancias entre el diagnóstico clínico y el anatomopatológico en un Servicio de Cuidados Intensivos Polivalente

Abstract: Autopsy continues to be a useful tool to assess quality of clinical diagnosis. The diagnostic errors with therapeutic repercussion are bacterial infections and cardiovascular disease. Patients with a stay less than 24 hours have a higher rate of type I diagnostic errors.

Cited by 7 publications

References 25 publications

Monocyte distribution width (MDW) as an infection indicator in severe patients attending in the Emergency Department: a pilot study

Monocyte distribution width (MDW) as an infection indicator in severe patients attending in the Emergency Department: a pilot study

Discrepancias entre el diagnóstico clínico y el diagnóstico anatomopatológico en la mortalidad temprana del trasplante pulmonar

Perspectivas futuras para la autopsia clínica en los pacientes procedentes de la unidad de cuidados críticos y urgencias

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