• Posted August 6, 2024

Is It Really Pneumonia? Study Casts Doubt on Hospital Diagnoses

Hospitals could be frequently misdiagnosing pneumonia, causing patients to receive the wrong treatments and potentially become deathly ill, a new study finds.

More than half the time, a pneumonia diagnosis will change following a patient’s admission to the hospital, researchers report.

Either someone initially diagnosed with pneumonia will end up actually sick from something else, or the diagnosis of pneumonia was missed when a patient entered the hospital, results show.

“Pneumonia can seem like a clear-cut diagnosis, but there is actually quite a bit of overlap with other diagnoses that can mimic pneumonia,” said lead researcher Dr. Barbara Jones, a pulmonary and critical care physician at University of Utah Health.

For the study, published Aug. 5 in the Annals of Internal Medicine, researchers analyzed medical records from more than 100 VA medical centers across the country. More than 10% of hospitalizations involved a pneumonia diagnosis.

Pneumonia is an infection in one or both lungs that causes the air sacs to fill with fluid or pus, the National Institute on Health says. It can be caused by bacterial, viral or fungal infections.

Researchers found that a third of patients who were ultimately diagnosed with pneumonia were not diagnosed with the condition when they entered the hospital.

At the same time, nearly 40% of people initially diagnosed with pneumonia actually were sick with something else, and their diagnosis was revised during treatment.

This uncertainty was often evident in doctors’ notes, results show.

More than half the time (58%), notes on pneumonia diagnoses in the ER expressed uncertainty. Likewise, notes on diagnosis at the time of discharge expressed uncertainty about half the time (48%).

People tended to receive more treatments with an initial diagnosis of pneumonia that wound up being something else, researchers found. However, in general they didn’t do worse than other patients.

But patients with pneumonia missed from the start tended to have worse outcomes, even if the condition was finally detected, researchers found.

Doctors and patients should keep in mind that pneumonia is a tricky condition to diagnose, and be flexible as treatment proceeds, Jones said.

“Both patients and clinicians need to pay attention to their recovery and question the diagnosis if they don’t get better with treatment,” Jones said in a university news release.

More information

The National Institutes of Health has more on pneumonia.

SOURCE: University of Utah, news release, Aug. 5, 2024