OBJECTIVES: This is an audit project aiming to evaluate the proportion of misdiagnosis among hospitalised communityacquired pneumonia (CAP) patients in the Respiratory wards of Penang General Hospital based on their initial presentation data, and their associated outcomes.
METHODS: We reviewed the medical notes and initial chest radiographs of 188 CAP patients who were admitted to respiratory wards. Misdiagnosis was defined as cases which lack suggestive clinical features and/or chest radiograph changes. In-hospital mortality and length of stay (LOS) were the outcomes of interest.
RESULTS: The study found that 38.8% (n=73) of the hospitalised CAP patients were misdiagnosed. The most common alternative diagnosis was upper respiratory tract infection (32.8%, n=24). There was no statistical difference between misdiagnosis and CAP patients in the demographic and clinical variables collected. In terms of outcomes, misdiagnosed patients were discharged earlier (mean LOS= 3.5±3.28 days vs. 7.7±15.29 days, p=0.03) but the in-hospital mortality difference was not statistically significant (p=0.07).
CONCLUSIONS: One third of our CAP admissions were misdiagnosed. Although initial misdiagnosis of CAP in our study did not show any increase in mortality or morbidity, a proper diagnosis of CAP will be helpful in preventing inappropriate prescription of antibiotics and unnecessary admission.
METHODS: Medical records of patients who were treated for LM in the Paediatric Surgical Centre Universitas Gadjah Mada from January 2015 to January 2019 were reviewed. Scoring systems were used to assess the outcomes, including reduction of size, problems of aesthetics, functional problems, complications, necessity of further interventions, and interventions' frequencies.
RESULTS: During the four-year study, we included 31 children, consisting of 6, 5, and 20 patients in Groups I, II, and III, respectively. The total score did not significantly differ between Groups I, II, and III (14.67±2.80 vs. 13.40±2.07 vs. 12.50±1.47, respectively; p=0.056). Group II scored better in aesthetic problems than other groups (p=0.001), Group III scored higher in necessity of further interventions compared to the other groups (p=0.026), and Group I was higher in interventions' frequencies than the other groups (p<0.001). However, there were no significant differences in reduction of size, functional problems, and complications among groups (p=0.554, 0.151, and 0.076, respectively).
CONCLUSIONS: There is no significant different effect of the three modalities treatment for LM, although one group might have more beneficial effects compared with the other groups due to different scoring system parameters. Further multicentre and prospective cohort studies with a larger number of patients are necessary to establish the existence and extent of our findings.