Table 3.
Crude and adjusted analysis of factors associated with major diagnostic errors
|
Type of error |
Crude analysis |
Adjusted analysis |
|||||
|---|---|---|---|---|---|---|---|
| None or minor* | Major | OR (95% CI) | p value† | OR (95%CI) | p value† | ||
| Case characteristics | |||||||
| Status of the patient | 0·1217 | 0·4110 | |||||
| Pregnant | 11 (20%) | 14 (40%) | 1 (ref) | .. | 1 (ref) | .. | |
| Delivery or abortion | 15 (27%) | 7 (20%) | 0·38 (0·12–1·23) | .. | 0·67 (0·08–5·26) | .. | |
| Postpartum | 30 (54%) | 14 (40%) | 0·38 (0·14–1·02) | .. | 0·35 (0·08–1·67) | .. | |
| Anamnesis at admission | |||||||
| Vaginal bleeding | 0·0382 | 0·2979 | |||||
| No | 26 (46%) | 23 (66%) | 1 (ref) | .. | 1 (ref) | .. | |
| Yes | 30 (54%) | 10 (29%) | 0·39 (0·16–0·95) | .. | 0·40 (0·07–2·26) | .. | |
| Unknown | 0 | 2 (6%) | .. | .. | .. | .. | |
| Hypertension | 0·8547 | .. | |||||
| No | 25 (45%) | 20 (57%) | 1 (ref) | .. | .. | .. | |
| Yes | 1 (2%) | 1 (3%) | 1·24 (0·12–12·87) | .. | .. | .. | |
| Unknown | 30 (54%) | 14 (40%) | .. | .. | .. | .. | |
| Pre-admission medication | 0·0414 | 0·0648 | |||||
| No | 34 (61%) | 14 (40%) | 1 (ref) | .. | 1 (ref) | .. | |
| Yes | 18 (32%) | 19 (54%) | 2·51 (1·04–6·07) | .. | 3·25 (0·93–11·35) | .. | |
| Unknown | 4 (7%) | 2 (6%) | .. | .. | .. | .. | |
| Axillary temperature | 37·03 (1·30) [33] | 37·49 (1·25) [23] | 1·31 (0·86–1·98) | 0·2057 | .. | .. | |
| Nutritional status | 0·8098 | .. | |||||
| Normal | 29 (52%) | 18 (51%) | 1 (ref) | .. | .. | .. | |
| Cachexia or malnutrition | 2 (4%) | 1 (3%) | 0·96 (0·12–7·86) | .. | .. | .. | |
| Obesity | 4 (7%) | 4 (11%) | 1·59 (0·38–6·66) | .. | .. | .. | |
| Unknown | 21 (38%) | 12 (34%) | .. | .. | .. | .. | |
| Oedemas | 0·6619 | .. | |||||
| No | 42 (75%) | 27 (77%) | 1 (ref) | .. | .. | .. | |
| Yes | 14 (25%) | 7 (20%) | 0·80 (0·29–2·18) | .. | .. | .. | |
| Unknown | 0 | 1 (3%) | .. | .. | .. | .. | |
| Pallor | 0·7733 | .. | |||||
| No | 23 (41%) | 15 (43%) | 1 (ref) | .. | .. | .. | |
| Yes | 33 (59%) | 19 (54%) | 0·88 (0·38–2·07) | .. | .. | .. | |
| Unknown | 0 | 1 (3%) | .. | .. | .. | .. | |
| Neurological exam | |||||||
| General status | 0·1174 | .. | |||||
| Conscious | 37 (66%) | 14 (40%) | 1 (ref) | 2·74 (0·09–85·22) | .. | ||
| Lethargy | 2 (4%) | 3 (9%) | 3·62 (0·64–20·47) | 1·69 (0·18–15·81) | .. | ||
| Confusion or agitation | 7 (12%) | 8 (23%) | 2·93 (0·92–9·29) | 1·98 (0·03–123·96) | .. | ||
| Unconscious | 10 (18%) | 10 (29%) | 2·59 (0·91–7·38) | 2·74 (0·09–85·22) | .. | ||
| Glasgow coma scale | 13·54 (3·42) [50] | 11·61 (3·84) [33] | 0·87 (0·77–0·98) | 0·0272 | 0·89 (0·57–1·40) | 0·6098 | |
| Stiff neck or meningeal syndrome | 0·5886 | .. | |||||
| No | 53 (95%) | 53 (95%) | 1 (ref) | .. | .. | .. | |
| Yes | 2 (4%) | 2 (4%) | 1·65 (0·27–10·02) | .. | .. | .. | |
| Unknown | 1 (2%) | 1 (2%) | .. | .. | .. | .. | |
| Obstetric history | |||||||
| Parity | 0·2647 | .. | |||||
| Primigravidae | 8 (14%) | 8 (23%) | 1 (ref) | .. | .. | .. | |
| Multigravidae | 48 (86%) | 26 (74%) | 0·55 (0·19–1·58) | .. | .. | .. | |
| Unknown | 0 | 1 (3%) | .. | .. | .. | .. | |
| Gestational age (weeks) | 29·06 (10·62) [48] | 26·83 (8·98) [30] | 0·98 (0·94–1·02) | 0·3405 | .. | .. | |
| Fever during pregnancy | 0·0554 | 0·6953 | |||||
| No | 32 (57%) | 12 (34%) | 1 (ref) | .. | 1 (ref) | .. | |
| Yes | 14 (25%) | 14 (40%) | 2·60 (0·98–6·91) | .. | 0·65 (0·07–5·74) | .. | |
| Unknown | 10 (18%) | 9 (26%) | .. | .. | .. | .. | |
| Malaria during pregnancy | 0·8330 | .. | |||||
| No | 24 (43%) | 14 (40%) | 1 (ref) | .. | .. | .. | |
| Yes | 3 (5%) | 2 (6%) | 1·21 (0·21–6·93) | .. | .. | .. | |
| Unknown | 29 (52%) | 19 (54%) | .. | .. | .. | .. | |
| Anaemia | 0·1117 | 0·7062 | |||||
| No | 14 (25%) | 15 (43%) | 1 (ref) | .. | 1 (ref) | .. | |
| Yes | 34 (61%) | 17 (49%) | 0·47 (0·19–1·19) | .. | 1·34 (0·29–6·24) | .. | |
| Unknown | 8 (14%) | 3 (9%) | .. | .. | .. | .. | |
| Clinical course | |||||||
| Fever during admission | 0·0214 | 0·4492 | |||||
| No | 35 (62%) | 12 (34%) | 1 (ref) | .. | 1 (ref) | .. | |
| Yes | 20 (36%) | 20 (57%) | 2·84 (1·17–6·91) | .. | 2·09 (0·31–14·01) | .. | |
| Unknown | 1 (2%) | 3 (9%) | .. | .. | .. | .. | |
| HIV status | 0·4325 | .. | |||||
| Negative | 4 (7%) | 6 (17%) | 1 (ref) | .. | .. | .. | |
| Positive | 26 (46%) | 22 (63%) | 0·59 (0·16–2·22) | .. | .. | .. | |
| Unknown | 26 (46%) | 7 (20%) | .. | .. | .. | .. | |
| Lower haemoglobin | 7·15 (2·49) [42] | 7·87 (2·68) [24] | 1·11 (0·92–1·35) | 0·2787 | .. | .. | |
| Malaria rapid test | 0·1598 | .. | |||||
| Negative | 19 (34%) | 18 (51%) | 1 (ref) | .. | .. | .. | |
| Positive | 4 (7%) | 0 (0%) | 0·12 (0·01–2·33) | .. | .. | .. | |
| Unknown | 33 (59%) | 17 (49%) | .. | .. | .. | .. | |
Data are n (%) or mean (SD) [n], unless otherwise indicated. OR=odds ratio.
*
There were no minor clinical errors identified for case characteristics, anamnesis at admission, or neurological exam.
†
Penalised logistic regression.