| Risk factors for the misdiagnosis of pneumothorax in the intensive care unit. | |
| | |
MedLine Citation:
|
PMID: 2055079 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: To identify risk factors predisposing to the misdiagnosis of pneumothorax in the ICU. DESIGN: A prospective case series investigation. SETTING: A medical ICU service of a military referral hospital. PATIENTS: All adult medical ICU patients were evaluated during a 12-month period. Of 464 admissions, 28 (6%) were found to have acquired a pneumothorax during their medical ICU stay. INTERVENTIONS: Nineteen (67.9%) patients with pneumothorax were diagnosed correctly on initial presentation of their pneumothorax. The remaining nine (32.1%) patients' pneumothoraces were misdiagnosed at initial presentation. MEASUREMENTS AND MAIN RESULTS: Tension pneumothorax occurred more frequently in patients with an initially misdiagnosed pneumothorax (33.3%) than in patients with pneumothoraces that were correctly diagnosed during their medical ICU stay (5.3%) (p less than .06). Thirteen variables chosen prospectively were examined using a chi-square statistic. The following four variables occurred statistically more often in nine patients with an initially misdiagnosed pneumothorax: a) mechanical ventilation required at the time of the development of pneumothorax (p less than .05); b) an atypical radiographic location of the pneumothorax (p less than .05); c) altered mental status exhibited at the time of pneumothorax presentation (p less than .05); and d) development of pneumothorax after peak physician staffing hours (p less than .02). CONCLUSIONS: Certain medical ICU patients appear to be at higher risk for the initial misdiagnosis of pneumothorax. Familiarity with factors predisposing to this problem should allow for a higher index of suspicion for the diagnosis of pneumothorax in critically ill patients and possibly improve the early detection of pneumothorax. |
| | |
Authors:
|
M H Kollef |
Related Documents
:
|
19255109 - Acute intermittent porphyria as a cause of respiratory failure: case report. 22622349 - Increased rectal microbial richness is associated with the presence of colorectal adeno... 20351029 - Repaired oesophageal atresia: respiratory morbidity and pulmonary function in adults. 11282759 - Noninvasive versus conventional mechanical ventilation. an epidemiologic survey. 1332559 - Antimyeloperoxidase autoantibody-associated necrotizing alveolar capillaritis. 22016379 - Fatigue in bronchiectasis. 6648499 - The prevalence of gastrinomas in recurrent peptic ulceration. 3422049 - Four patients with myelodysplastic syndrome with translocation (1;7)(p11;p11) including... 19514879 - Acute topiramate overdose--clinical manifestations. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Critical care medicine Volume: 19 ISSN: 0090-3493 ISO Abbreviation: Crit. Care Med. Publication Date: 1991 Jul |
Date Detail:
|
Created Date: 1991-08-01 Completed Date: 1991-08-01 Revised Date: 2004-11-17 |
Medline Journal Info:
|
Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 906-10 Citation Subset: AIM; IM |
Affiliation:
|
Medical Intensive Care Unit, Fitzsimons Army Medical Center, Aurora, CO 80045-5001. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Causality Diagnostic Errors Female Humans Intensive Care Units* Male Medical Staff, Hospital / supply & distribution Middle Aged Orientation Pneumothorax / diagnosis*, epidemiology, radiography Prospective Studies Respiration, Artificial / adverse effects |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Use of the Natural Death Act in pediatric patients.
Next Document: Endotracheal and endobronchial lidocaine administration: effects on plasma lidocaine concentration a...