In-hospital Mortality Associated with the Misdiagnosis or Unidentified Site of Infection at Admission

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Rapid detection, early resuscitation, and appropriate antibiotic use are crucial for sepsis care. Accurate identification of the site of infection may facilitate a timely provision of appropriate care. We aimed to investigate the relationship between misdiagnosis of the site of infection at initial examination and in-hospital mortality. Among patients with infection, misdiagnosed site of infection is associated with a > 10% increase in in-hospital mortality. Of 974 patients included in the analysis, 11.6% were misdiagnosed. Patients diagnosed with lung, intra-abdominal, urinary, soft tissue, and CNS infection at the initial examination, 4.2%, 3.8%, 13.6%, 10.9%, and 58.3% respectively, turned out to have an infection at a different site. This was a secondary-multicenter prospective cohort study involving 37 emergency departments.

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