OBJECTIVES: To assess to which extent exacerbated @entity1030 ( @entity1030 ) remains unrecognized in the emergency department, which factors account for misdiagnosis and which are the effects of misdiagnosis on @entity1 's management. DESIGN: Retrospective study and stratified random sampling method as selection criterion. SETTING: University Hospital. SUBJECTS: Eighty @entity1 representative of those discharged from the wards of medicine with a diagnosis of exacerbated @entity1030 and 72 having a discharge diagnosis of @entity453 ( @entity453 ) were studied. MAIN OUTCOME MEASURES: Degree of concordance between admission and discharge diagnosis; presenting symptoms and signs of @entity1 correctly or incorrectly classified on admission; impact of diagnostic procedures carried out by the physician on call on @entity1 's management. RESULTS: The correct diagnosis was missed on admission in 13/80 @entity1030 and 3/72 @entity453 @entity1 (chi(2): 5.87, P=0.015). The prevalence of the following presenting features distinguished the 67 @entity1030 @entity1 who were correctly classified on admission from the remaining 13: severe @entity425 (21 vs. 10, chi(2): 9.53, P=0.002), @entity1353 (60 vs. 3, chi(2): 28.75, P < 0.001), and limb @entity4 (14 vs. 6, chi(2): 3.70, P=0.054). Critical @entity519 was diagnosed and treated only after admission in 19 @entity1030 @entity1 . CONCLUSIONS: Exacerbated @entity1030 frequently escapes recognition in the emergency room, mainly if severe @entity425 and limb @entity4 are its presenting features. Arterial blood gas analysis is not systematically performed in the emergency room and, consequently, @entity26 therapy is either not administered or given to selected @entity1030 @entity1 on an empirical basis.

Exacerbated XXXX : a frequently unrecognized condition.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity1353 :: ('MESH:D004417', 'Disease') :: ['dyspnea'] @entity4 :: ('MESH:D004487', 'Disease') :: ['oedema'] @entity26 :: ('MESH:D010100', 'Chemical') :: ['oxygen'] @entity425 :: ('MESH:D018908', 'Disease') :: ['weakness'] @entity519 :: ('MESH:D000860', 'Disease') :: ['hypoxemia'] @entity1030 :: ('MESH:D029424', 'Disease') :: ['chronic obstructive pulmonary disease', 'COPD'] @entity453 :: ('MESH:D003324', 'Disease') :: ['CAD', 'coronary artery disease']
@entity1030 :: (MESH:D029424,Disease) :: ['chronic obstructive pulmonary disease']
