Diagnosis of XXXX : a multicentre cohort study.

@entity1 @entity1755 @entity1163 @entity591 @entity615 @entity158 @entity551
OBJECTIVE: The aim of this study was to describe the presentation of @entity1 with @entity1755 ( @entity1755 ) and identify factors contributing toward misdiagnosis. METHODS: This was an observational study of cases with a final diagnosis of @entity1755 assessed at nine Emergency Departments and managed at one of two regional vascular centres in the UK. RESULTS: Eighty-five consecutive cases were included. Seventeen [20.0%, 95% confidence interval (CI) 11.5-28.5%] @entity1 reported important symptoms up to 3 weeks before index presentation. In the Emergency Department, most @entity1 @entity615 , seven (8.2%, 95% CI 2.4-14.0%) additionally reported atypical @entity158 and ten (11.8%, 95% CI 4.9-18.7%) denied @entity158 altogether. @entity551 (36.5%, 95% CI 26.3-46.7%), @entity591 (18.8%, 95% CI 10.5-27.1%) and @entity1163 (36.5%, 95% CI 26.3-46.7%) were documented in a minority of cases. Distracting symptoms were present in 33 (38.8%, 95% CI 28.4-49.2%) @entity1 . The median time to diagnosis was 17.5   min (range immediate-12 days), and 21 (25.6%, 95% CI 16.3-34.9%) @entity1 were misdiagnosed during clinical assessment. CONCLUSION: The classical signs and symptoms or @entity1755 are not always present and @entity1 frequently show additional features that may confound the diagnosis. A high level of suspicion should be adopted for @entity1755 alongside a low threshold for immediate computed tomography. Further research is required to develop an objective clinical risk score or predictive tool for characterizing @entity1 at risk.
