Missed Serious Neurologic Conditions in Emergency Department Patients Discharged With Nonspecific Diagnoses of Headache or Back Pain

Annals of Emergency Medicine
Nicole M DuboshKohei Hasegawa

Abstract

Serious neurologic conditions can be missed on initial emergency department (ED) visit and discharge diagnosis oftentimes remains a nonspecific symptom. We aim to examine the incidence of potential harm from serious neurologic conditions in ED patients discharged with a nonspecific diagnosis of headache or back pain, identify specific missed conditions, and determine risk factors for potential misdiagnosis-related harm. This was a retrospective analysis using the population-based data of 6 US states from the State Emergency Department Databases and State Inpatient Databases from 2006 through 2012. We identified adults (≥18 years) discharged from the ED with a diagnosis of atraumatic headache or back pain. The primary outcome was a composite of return ED visit and hospitalization for primary diagnosis of a serious neurologic condition or inhospital death within 30 days of ED discharge. There were 2,101,081 ED discharges with a nonspecific diagnosis of headache and 1,381,614 discharges with a nonspecific diagnosis of back pain. Overall, 0.5% of the headache patients and 0.2% of back pain patients had a primary outcome. The most common missed condition for headache was ischemic stroke (18.1%). The most common missed condition for ...Continue Reading

Citations

Jul 16, 2020·JAAPA : Official Journal of the American Academy of Physician Assistants·Michael G DePalma
Jul 31, 2019·Current Pain and Headache Reports·Oleg Otlivanchik, Ava L Liberman
Aug 3, 2020·JAAPA : Official Journal of the American Academy of Physician Assistants·Michael G DePalma
May 22, 2021·Neuropsychiatric Disease and Treatment·Emma J C Wallace, Ava L Liberman
Jul 11, 2021·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Amy Z ZhouSriram Ramgopal
Nov 17, 2020·The American Journal of Emergency Medicine·Ava L LibermanRichard B Lipton
Jul 27, 2021·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Ava L LibermanDavid E Newman-Toker
Oct 4, 2020·Pediatrics·Amy Z ZhouSriram Ramgopal

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cancer Disparities

Cancer disparities refers to differences in cancer outcomes (e.g., number of cancer cases, related health complications) across population groups.