Hospitalised adults with pneumonia are frequently misclassified as another diagnosis. (April 2019)

• Record Type: Journal Article
• Authors: Brendish, Nathan J.; Malachira, Ahalya K.; Beard, Kate R.; Armstrong, Lawrence; Lillie, Patrick J.; Clark, Tristan W.
• Is Part Of: Respiratory medicine. Volume 150(2019)
• Page Start: 81
• Page End: 84
• Publication Date: 2019-04
• Subjects: Pneumonia -- Diagnosis; Chest -- Diseases -- Periodicals; Chest -- Diseases -- Great Britain -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Appareil respiratoire -- Maladies -- Périodiques; Thorax -- Maladies -- Périodiques; Appareil respiratoire -- Maladies -- Traitement -- Périodiques; Electronic journals; 616.2
• DOI: 10.1016/j.rmed.2019.02.013
• Languages: English
• ISSNs: 0954-6111

Abstract

Abstract: Using data from a large randomised controlled trial of adults hospitalised with acute respiratory illness, we examined the reliability of pneumonia diagnosis on discharge documentation. 50 (28.2%) of 177 patients with a pneumonia diagnosis had no radiological evidence of pneumonia. 67 (34.9%) of 192 patients with clinico-radiological evidence of pneumonia did not have a diagnosis of pneumonia listed; 'COPD exacerbation' or 'lower respiratory tract infection' was often listed instead. These patients more frequently had a respiratory comorbidity and lower oxygen saturations, CRP and temperature at presentation. Pneumonia diagnoses misclassification on discharge documentation may have clinical, financial, and research data implications. Highlights: We examined discharge data for 720 adults hospitalised with acute respiratory illness. Adults with pneumonia often did not have pneumonia recorded on discharge information. Adults with pneumonia were often misclassified as other diagnoses. Adults with pneumonia not recorded vs correctly classified had different demographics. Adults recorded as having pneumonia often had no evidence of pneumonia on imaging.