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Diagnostic error rates and associated factors for lower gastrointestinal perforation

Lower gastrointestinal perforation is rare and challenging to diagnose in patients presenting with an acute abdomen. However, no study has examined the frequency and associated factors of diagnostic errors related to lower gastrointestinal perforation. This large-scale multicenter retrospective stud...

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Autores principales: Harada, Taku, Watari, Takashi, Watanuki, Satoshi, Hiroshige, Juichi, Kushiro, Seiko, Miyagami, Taiju, Syusa, Syunsuke, Suzuki, Satoshi, Hiyoshi, Tetsuya, Hasegawa, Suguru, Nabeshima, Shigeki, Aihara, Hidetoshi, Yamashita, Shun, Tago, Masaki, Yoshimura, Fumitaka, Kunitomo, Kotaro, Tsuji, Takahiro, Hirose, Masanori, Tsuchida, Tomoya, Shimizu, Taro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8770624/
https://www.ncbi.nlm.nih.gov/pubmed/35046455
http://dx.doi.org/10.1038/s41598-021-04762-y
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author Harada, Taku
Watari, Takashi
Watanuki, Satoshi
Hiroshige, Juichi
Kushiro, Seiko
Miyagami, Taiju
Syusa, Syunsuke
Suzuki, Satoshi
Hiyoshi, Tetsuya
Hasegawa, Suguru
Nabeshima, Shigeki
Aihara, Hidetoshi
Yamashita, Shun
Tago, Masaki
Yoshimura, Fumitaka
Kunitomo, Kotaro
Tsuji, Takahiro
Hirose, Masanori
Tsuchida, Tomoya
Shimizu, Taro
author_facet Harada, Taku
Watari, Takashi
Watanuki, Satoshi
Hiroshige, Juichi
Kushiro, Seiko
Miyagami, Taiju
Syusa, Syunsuke
Suzuki, Satoshi
Hiyoshi, Tetsuya
Hasegawa, Suguru
Nabeshima, Shigeki
Aihara, Hidetoshi
Yamashita, Shun
Tago, Masaki
Yoshimura, Fumitaka
Kunitomo, Kotaro
Tsuji, Takahiro
Hirose, Masanori
Tsuchida, Tomoya
Shimizu, Taro
author_sort Harada, Taku
collection PubMed
description Lower gastrointestinal perforation is rare and challenging to diagnose in patients presenting with an acute abdomen. However, no study has examined the frequency and associated factors of diagnostic errors related to lower gastrointestinal perforation. This large-scale multicenter retrospective study investigated the frequency of diagnostic errors and identified the associated factors. Factors at the level of the patient, symptoms, situation, and physician were included in the analysis. Data were collected from nine institutions, between January 1, 2015 and December 31, 2019. Timely diagnosis was defined as diagnosis at the first visit in computed tomography (CT)-capable facilities or referral to an appropriate medical institution immediately following the first visit to a non-CT-capable facility. Cases not meeting this definition were defined as diagnostic errors that resulted in delayed diagnosis. Of the 439 cases of lower gastrointestinal perforation identified, delayed diagnosis occurred in 138 cases (31.4%). Multivariate logistic regression analysis revealed a significant association between examination by a non-generalist and delayed diagnosis. Other factors showing a tendency with delayed diagnosis included presence of fever, absence of abdominal tenderness, and unavailability of urgent radiology reports. Initial misdiagnoses were mainly gastroenteritis, constipation, and small bowel obstruction. In conclusion, diagnostic errors occurred in about one-third of patients with a lower gastrointestinal perforation.
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spelling pubmed-87706242022-01-24 Diagnostic error rates and associated factors for lower gastrointestinal perforation Harada, Taku Watari, Takashi Watanuki, Satoshi Hiroshige, Juichi Kushiro, Seiko Miyagami, Taiju Syusa, Syunsuke Suzuki, Satoshi Hiyoshi, Tetsuya Hasegawa, Suguru Nabeshima, Shigeki Aihara, Hidetoshi Yamashita, Shun Tago, Masaki Yoshimura, Fumitaka Kunitomo, Kotaro Tsuji, Takahiro Hirose, Masanori Tsuchida, Tomoya Shimizu, Taro Sci Rep Article Lower gastrointestinal perforation is rare and challenging to diagnose in patients presenting with an acute abdomen. However, no study has examined the frequency and associated factors of diagnostic errors related to lower gastrointestinal perforation. This large-scale multicenter retrospective study investigated the frequency of diagnostic errors and identified the associated factors. Factors at the level of the patient, symptoms, situation, and physician were included in the analysis. Data were collected from nine institutions, between January 1, 2015 and December 31, 2019. Timely diagnosis was defined as diagnosis at the first visit in computed tomography (CT)-capable facilities or referral to an appropriate medical institution immediately following the first visit to a non-CT-capable facility. Cases not meeting this definition were defined as diagnostic errors that resulted in delayed diagnosis. Of the 439 cases of lower gastrointestinal perforation identified, delayed diagnosis occurred in 138 cases (31.4%). Multivariate logistic regression analysis revealed a significant association between examination by a non-generalist and delayed diagnosis. Other factors showing a tendency with delayed diagnosis included presence of fever, absence of abdominal tenderness, and unavailability of urgent radiology reports. Initial misdiagnoses were mainly gastroenteritis, constipation, and small bowel obstruction. In conclusion, diagnostic errors occurred in about one-third of patients with a lower gastrointestinal perforation. Nature Publishing Group UK 2022-01-19 /pmc/articles/PMC8770624/ /pubmed/35046455 http://dx.doi.org/10.1038/s41598-021-04762-y Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Harada, Taku
Watari, Takashi
Watanuki, Satoshi
Hiroshige, Juichi
Kushiro, Seiko
Miyagami, Taiju
Syusa, Syunsuke
Suzuki, Satoshi
Hiyoshi, Tetsuya
Hasegawa, Suguru
Nabeshima, Shigeki
Aihara, Hidetoshi
Yamashita, Shun
Tago, Masaki
Yoshimura, Fumitaka
Kunitomo, Kotaro
Tsuji, Takahiro
Hirose, Masanori
Tsuchida, Tomoya
Shimizu, Taro
Diagnostic error rates and associated factors for lower gastrointestinal perforation
title Diagnostic error rates and associated factors for lower gastrointestinal perforation
title_full Diagnostic error rates and associated factors for lower gastrointestinal perforation
title_fullStr Diagnostic error rates and associated factors for lower gastrointestinal perforation
title_full_unstemmed Diagnostic error rates and associated factors for lower gastrointestinal perforation
title_short Diagnostic error rates and associated factors for lower gastrointestinal perforation
title_sort diagnostic error rates and associated factors for lower gastrointestinal perforation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8770624/
https://www.ncbi.nlm.nih.gov/pubmed/35046455
http://dx.doi.org/10.1038/s41598-021-04762-y
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