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Importance of correct initial diagnosis in acutely admitted dyspoeic patients

Dyspnoea is a common chief complaint in emergency department (ED) patients and is associated with a high mortality. In the February issue of Danish Medical Journal, Ovesen et al. present results of a retrospective study from Aarhus University Hospital investigating the association between a change in diagnosis from ED contact to hospital discharge and length of stay, readmission and mortality in patients whose chief complaint was dyspnoea. Study outcomes where analyzed in 524 patients of whom the majority had COPD or pneumonia. The authors report that a change in diagnosis was associated with a longer hospital stay and an almost twice as high 30-day mortality (5% in the concordant and 10% in the discordant group). The study concludes that the effort used to acquire diagnostic certainty in the ED may have an impact that lasts throughout the entire hospital stay.
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Change in diagnosis from the emergency department to hospital discharge in dyspnoeic patients
Stig Holm Ovesen, Søren Flink Sørensen, Marianne Lisby et al

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