| Objective To evaluate the present status of pulmonary embolism (PE) misdiagnosis in China.Methods Literatures on PE misdiagnosis published in Chinese language journals between 2001 and 2008 were identified by searching the China Hospital Knowledge Database in China National Knowledge Infrastructure Web ( CNKI-CHKD ),and Wanfang database. Retrospective review items include: patient symptoms, medical examination tools, treatments and prognosis, causes of death, hospitals involved. The recent situation on PE misdiagnosis was also compared with that in year between 1980 to 2000.Results (1) A total of 205 literatures with 2653 misdiagnosed PE patients were found. ( 2 ) Once the misdiagnosis be corrected, the prognosis could be improved by antithrombotic and thrombolytic therapies compared with those without antithrombotic and thrombolytic therapies (OR 12.25, 95% CI 6.199-24.208) . The major causes of death were sudden death, resistant shock in patients without antithrombotic and thrombolytic therapies while the causes were sudden death, cerebral hemorrhage and resistant shock in PE patients received antithrombotic and thrombolytic therapies. ( 3) Literatures on PE misdiagnosis were most from provincial hospitals [ 37 papers with 542 cases (17.6% , 20.8% ) ] and municipal hospitals [ 117 papers with 1480 cases ( 57.1% , 57.0% ) ]. (4) PE was misdiagnosed to more than 80 kinds of diseases and the top 4 were coronary heart disease in 852 cases (32.8%), pneumonia in 385 cases (14.8% ) , congestive heart failure in 223 cases (8.5% ) and pleurisy in 200 cases (7.7%) .Conclusions ( 1) PE misdiagnosis is still a critical issue now in China and early diagnosis and effective treatment is essential for a better prognosis. (2)The differential diagnosis among PE and coronary heart disease and pneumonia need to be emphasized to avoid PE misdiagnosis. (3) Efforts should be made through continuing education on clinical professionals to improve their knowledge on PE in China. |
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