Impact of diagnostic errors on adverse outcomes: learning from emergency department revisits with repeat CT or MRI

Insights into Imaging

Seon-Ok Kim¹  Gil-Sun Hong²  Kye Jin Park²  Ju Hee Lee²  Yura Ahn²  Choong Wook Lee² 

[1] Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, Republic of Korea;Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, 05505, Songpa-gu, Seoul, Republic of Korea;

关键词: Emergency health services;    Diagnostic imaging;    Diagnostic errors;    Quality indicators;    Adverse outcomes;   

DOI  :  10.1186/s13244-021-01108-0

来源: Springer

【 摘 要 】

BackgroundTo investigate diagnostic errors and their association with adverse outcomes (AOs) during patient revisits with repeat imaging (RVRIs) in the emergency department (ED).ResultsDiagnostic errors stemming from index imaging studies and AOs within 30 days in 1054 RVRIs (≤ 7 days) from 2005 to 2015 were retrospectively analyzed according to revisit timing (early [≤ 72 h] or late [> 72 h to 7 days] RVRIs). Risk factors for AOs were assessed using multivariable logistic analysis. The AO rate in the diagnostic error group was significantly higher than that in the non-error group (33.3% [77 of 231] vs. 14.8% [122 of 823], p < .001). The AO rate was the highest in early revisits within 72 h if diagnostic errors occurred (36.2%, 54 of 149). The most common diseases associated with diagnostic errors were digestive diseases in the radiologic misdiagnosis category (47.5%, 28 of 59) and neurologic diseases in the delayed radiology reporting time (46.8%, 29 of 62) and clinician error (27.3%, 30 of 110) categories. In the matched set of the AO and non-AO groups, multivariable logistic regression analysis revealed that the following diagnostic errors contributed to AO occurrence: radiologic error (odds ratio [OR] 3.56; p < .001) in total RVRIs, radiologic error (OR 3.70; p = .001) and clinician error (OR 4.82; p = .03) in early RVRIs, and radiologic error (OR 3.36; p = .02) in late RVRIs.ConclusionDiagnostic errors in index imaging studies are strongly associated with high AO rates in RVRIs in the ED.

【 授权许可】

CC BY