Diagnostic pitfalls in obesity hypoventilation syndrome at the emergency department: a case series
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Abstract
Objective: To report cases of patients with a subsequent diagnosis of obesity hypoventilation syndrome and retrospectively analyze the diagnostic pitfalls related to this condition in emergency care settings. Methods: An observational, descriptive, exploratory, and retrospective study based on the medical records of patients who sought care at public and private emergency services. Results: A total of 11 cases of obesity hypoventilation syndrome diagnosed after emergency department visits were evaluated. The patients had a mean body mass index of 46.2 kg/m². In 90.9% of cases, obesity hypoventilation syndrome was not initially diagnosed in the emergency setting. The main reasons for seeking emergency care were respiratory infections and cardiac decompensation. All patients had symptoms of obstructive sleep apnea, and 90.9% were misdiagnosed with chronic obstructive pulmonary disease. One patient died, and prolonged hospital stays were documented. Conclusion: There is a limited understanding of obesity hypoventilation syndrome in emergency units, leading to challenges in achieving accurate diagnoses and, consequently, appropriate treatment.
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