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Premortem clinical diagnoses and postmortem autopsy findings: discrepancies in critically ill cancer patients
INTRODUCTION: Limited data are available regarding the relationship of premortem clinical diagnoses and postmortem autopsy findings in cancer patients who die in an oncologic intensive care unit (ICU). The purposes of this study were to compare the premortem clinical and postmortem diagnoses of canc...
Autores principales: | , , , , , |
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Formato: | Texto |
Lenguaje: | English |
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BioMed Central
2007
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2206477/ https://www.ncbi.nlm.nih.gov/pubmed/17448238 http://dx.doi.org/10.1186/cc5782 |
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author | Pastores, Stephen M Dulu, Alina Voigt, Louis Raoof, Nina Alicea, Margarita Halpern, Neil A |
author_facet | Pastores, Stephen M Dulu, Alina Voigt, Louis Raoof, Nina Alicea, Margarita Halpern, Neil A |
author_sort | Pastores, Stephen M |
collection | PubMed |
description | INTRODUCTION: Limited data are available regarding the relationship of premortem clinical diagnoses and postmortem autopsy findings in cancer patients who die in an oncologic intensive care unit (ICU). The purposes of this study were to compare the premortem clinical and postmortem diagnoses of cancer patients who died in the ICU and to analyze any discrepancies between them. METHODS: This is a retrospective review of medical records and autopsy reports of all cancer patients who died in a medical-surgical ICU and had an autopsy performed between 1 January 1999 and 30 September 2005 at a tertiary care cancer center. Premortem clinical diagnoses were compared with the postmortem findings. Major missed diagnoses were identified and classified, according to the Goldman criteria, into class I and class II discrepancies. RESULTS: Of 658 deaths in the ICU during the study period, 86 (13%) autopsies were performed. Of the 86 patients, 22 (26%) had 25 major missed diagnoses, 12 (54%) patients had class I discrepancies, 7 (32%) had class II discrepancies, and 3 (14%) had both class I and class II discrepancies. Class I discrepancies were due to opportunistic infections (67%) and cardiac complications (33%), whereas class II discrepancies were due to cardiopulmonary complications (70%) and opportunistic infections (30%). CONCLUSION: There was a discrepancy rate of 26% between premortem clinical diagnoses and postmortem findings in cancer patients who died in a medical-surgical ICU at a tertiary care cancer center. Our findings underscore the need for enhanced surveillance, monitoring, and treatment of infections and cardiopulmonary disorders in critically ill cancer patients. |
format | Text |
id | pubmed-2206477 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2007 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-22064772008-01-19 Premortem clinical diagnoses and postmortem autopsy findings: discrepancies in critically ill cancer patients Pastores, Stephen M Dulu, Alina Voigt, Louis Raoof, Nina Alicea, Margarita Halpern, Neil A Crit Care Research INTRODUCTION: Limited data are available regarding the relationship of premortem clinical diagnoses and postmortem autopsy findings in cancer patients who die in an oncologic intensive care unit (ICU). The purposes of this study were to compare the premortem clinical and postmortem diagnoses of cancer patients who died in the ICU and to analyze any discrepancies between them. METHODS: This is a retrospective review of medical records and autopsy reports of all cancer patients who died in a medical-surgical ICU and had an autopsy performed between 1 January 1999 and 30 September 2005 at a tertiary care cancer center. Premortem clinical diagnoses were compared with the postmortem findings. Major missed diagnoses were identified and classified, according to the Goldman criteria, into class I and class II discrepancies. RESULTS: Of 658 deaths in the ICU during the study period, 86 (13%) autopsies were performed. Of the 86 patients, 22 (26%) had 25 major missed diagnoses, 12 (54%) patients had class I discrepancies, 7 (32%) had class II discrepancies, and 3 (14%) had both class I and class II discrepancies. Class I discrepancies were due to opportunistic infections (67%) and cardiac complications (33%), whereas class II discrepancies were due to cardiopulmonary complications (70%) and opportunistic infections (30%). CONCLUSION: There was a discrepancy rate of 26% between premortem clinical diagnoses and postmortem findings in cancer patients who died in a medical-surgical ICU at a tertiary care cancer center. Our findings underscore the need for enhanced surveillance, monitoring, and treatment of infections and cardiopulmonary disorders in critically ill cancer patients. BioMed Central 2007 2007-04-20 /pmc/articles/PMC2206477/ /pubmed/17448238 http://dx.doi.org/10.1186/cc5782 Text en Copyright © 2007 Pastores et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Pastores, Stephen M Dulu, Alina Voigt, Louis Raoof, Nina Alicea, Margarita Halpern, Neil A Premortem clinical diagnoses and postmortem autopsy findings: discrepancies in critically ill cancer patients |
title | Premortem clinical diagnoses and postmortem autopsy findings: discrepancies in critically ill cancer patients |
title_full | Premortem clinical diagnoses and postmortem autopsy findings: discrepancies in critically ill cancer patients |
title_fullStr | Premortem clinical diagnoses and postmortem autopsy findings: discrepancies in critically ill cancer patients |
title_full_unstemmed | Premortem clinical diagnoses and postmortem autopsy findings: discrepancies in critically ill cancer patients |
title_short | Premortem clinical diagnoses and postmortem autopsy findings: discrepancies in critically ill cancer patients |
title_sort | premortem clinical diagnoses and postmortem autopsy findings: discrepancies in critically ill cancer patients |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2206477/ https://www.ncbi.nlm.nih.gov/pubmed/17448238 http://dx.doi.org/10.1186/cc5782 |
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