Table 1. Characteristics of 1477 Patients With Misdiagnosed and Correctly Diagnosed Site of Infectiona .
| Characteristic | Misdiagnosed (n = 171) | Correctly diagnosed (n = 1306) | P value |
|---|---|---|---|
| Demographic characteristics and medical history | |||
| Age, median (IQR), y | 72 (64-80) | 68 (55-78) | <.001 |
| Sex | |||
| Male | 89 (52) | 731 (56) | .33 |
| Female | 82 (48) | 575 (44) | |
| Nursing home resident | 18 (10.5) | 143 (10.9) | .87 |
| History of cardiovascular disease | 96 (56.1) | 544 (41.7) | <.001 |
| History of pulmonary disease | 34 (19.9) | 392 (30.0) | <.001 |
| History of kidney disease | 34 (19.9) | 151 (11.6) | .002 |
| Dementia | 14 (8.2) | 50 (3.8) | .008 |
| Charlson Comorbidity Index, median (IQR) | 4 (2-6) | 3 (1-5) | .003 |
| Vital signs | |||
| Initial SBP, median (IQR), mm Hg | 128 (110-150) | 129 (112-148) | .49 |
| Initial HR, median (IQR), beats/min | 98 (84-115) | 102 (89-115) | .16 |
| Initial BF, median (IQR), breaths/min | 20 (16-25) | 20 (16-26) | .08 |
| Altered mental status | 28 (16.8) | 105 (8.9) | .001 |
| Initial body temperature, median (IQR), °C | 38.5 (37.8-39.3) | 38.6 (37.9-39.2) | .40 |
| qSOFA score | |||
| 0 | 67 (43.5) | 496 (44.7) | .10 |
| 1 | 59 (38.3) | 475 (42.8) | |
| 2 | 23 (14.9) | 118 (10.6) | |
| 3 | 5 (3.2) | 21 (1.9) | |
| Laboratory results | |||
| CRP, median (IQR), mg/dL | 10.0 (4.0-18.3) | 9.5 (3.5-19.7) | .95 |
| WBCs, median (IQR), /μL | 11 300 (8600-16 100) | 12 100 (8400-16 800) | .44 |
| Positive urine sediment test resultb | 74 (43.3) | 429 (32.8) | .007 |
| Bacteremiac | 42 (24.6) | 218 (16.7) | .01 |
Abbreviations: BF, breathing frequency; CRP, C-reactive protein; HR, heart rate; qSOFA, quick Sequential Organ Failure Assessment; SBP, systolic blood pressure; WBCs, white blood cells.
SI conversion factors: To convert CRP to milligrams per liter, multiply by 10; WBCs to ×109/L, multiply by 0.001.
Data are presented as number (percentage) of patients unless otherwise indicated. Systolic blood pressure data are missing in 7 patients, HR data in 4 patients, BF data in 93 patients, altered mental status data in 131 patients, CRP data in 1 patient, WBC count data in 2 patients, data on leukocytes in urine sediment in 6 patients, and qSOFA data in 213 patients.
Positive urine sediment test result indicates nitrite positive or more than 5 WBCs per high-power field.
Present when within 48 hours after presentation at the emergency department a blood culture yielded a pathogen typical for the infection site.