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Research and guideline updates
Adults miscoded and misdiagnosed as having pneumonia: results from the British Thoracic Society pneumonia audit
  1. Priya Daniel1,
  2. Thomas Bewick2,
  3. Sally Welham3,
  4. Tricia M Mckeever4,
  5. Wei Shen Lim1
  6. for the British Thoracic Society
  1. 1Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK
  2. 2Department of Respiratory Medicine, Derby Teaching Hospitals NHS Foundation Trust, Derby, UK
  3. 3British Thoracic Society, London, UK
  4. 4Division of Epidemiology, University of Nottingham, Nottingham, UK
  1. Correspondence to Dr Priya Daniel, Department of Respiratory Medicine, David Evans Building, City Hospital Campus, Nottingham University Hospitals NHS Trust, Hucknall Road, Nottingham NG5 1PB, UK; priyasosha.daniel{at}nuh.nhs.uk

Abstract

A key objective of the British Thoracic Society national community-acquired pneumonia (CAP) audit was to determine the clinical characteristics and outcomes of hospitalised adults given a primary discharge code of pneumonia but who did not fulfil accepted diagnostic criteria for pneumonia. Adults miscoded as having pneumonia (n=1251) were older compared with adults with CAP (n=6660) (median 80 vs 78 years, p<0.001) and had more comorbid disease, significantly fewer respiratory symptoms (fever, cough, dyspnoea, pleuritic pain), more constitutional symptoms (general deterioration, falls) and significantly lower 30-day inpatient mortality (14.3% vs 17.0%, adjusted OR 0.75, p=0.003).

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Footnotes

  • Contributors WSL and SW were instrumental in organising the BTS national community-acquired pneumonia audit; PD and TMM analysed and interpreted the data and drafted the article; TMM provided statistical input; PD, TMM, TB, SW and WSL critically evaluated the article; all authors revised and reviewed the article prior to final approval.

  • Competing interests PD reports grants from Pfizer, other from Boehringer-Ingelheim, outside the submitted work. WSL reports that his institution has received unrestricted investigator initiated research funding from Pfizer for a pneumonia cohort study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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