Cause of death and significant disease found at autopsy

Friberg, Niklas; Ljungberg, O; Berglund, Erik; Berglund, David; Ljungberg, Richard; Alafuzoff, Irina; Englund, Elisabet

doi:10.1007/s00428-019-02672-z

Cited by 27 publications

(34 citation statements)

References 17 publications

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“…Regarding the demographic data of the deceased patients, a significantly higher number of male patients underwent a postmortem examination. These findings are consistent with previous publications [ 3 ]. According to Cameron et al, the reason for higher autopsy rates in male patients is the higher likelihood of female relatives to give the permission for a postmortem examination [ 17 ].…”

Section: Discussionsupporting

confidence: 94%

“…In Germany, a decline in overall numbers of autopsies of 30% between 2005 and 2014 was detected [ 1 ]. This number is concordant with previous reports from other countries such as France, Sweden, and the USA where the decline has been reported to be even more severe [ 2 , 3 ]. A survey among pathologists in Germany revealed an autopsy rate of patients who died in a hospital of 3.63% in 2013 and 3.39% in 2014 [ 4 ].…”

Section: Introductionsupporting

confidence: 93%

“…In the subsequent almost 30 years, medical progress has accelerated considerably. In recent publications however, the rate of major discrepancies remains considerably high with 19.5-28% [3,[9][10][11]. In oncological patients, detailed studies of postmortem examinations are lacking.…”

Section: Introductionmentioning

confidence: 99%

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Can low autopsy rates be increased? Yes, we can! Should postmortem examinations in oncology be performed? Yes, we should! A postmortem analysis of oncological cases

Waidhauser¹,

Martin²,

Trepel³

et al. 2020

Virchows Arch

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Ever declining autopsy rates have been a concern of pathologists as well as clinicians for decades. Notably, in the field of oncology, data on autopsies and discrepancies between clinical and autoptic diagnoses are particularly scarce. In this retrospective study, we show the effect of a simple catalog of measures consisting of a different approach to obtain consent for autopsy, structured conferencing, and systematic teaching of residents, as well as a close collaboration between clinicians and pathologists on the numbers of autopsies, especially of oncological patients. Additionally, postmortem examination protocols from the years 2015 until 2019 were analyzed, regarding rates of discrepancies between clinical and autoptic causes of death in this category of patients. Autopsy numbers could be significantly increased from a minimum in 2014 (60 autopsies) to a maximum in 2018 (142 autopsies) (p < 0.0001). In the 67 autopsies of oncological cases, a high rate of 51% of major discrepancy between clinical and autoptic causes of death could be detected. In contrast to the general reported decline of autopsy rates, we present rising autopsy numbers over the past 5 years with an increasing number of oncological cases who underwent a postmortem examination. The high percentage of major discrepancies between clinical and autopsy diagnosis is in contrast to an expected decrease of major discrepancies in times of precise diagnostic methods and underlines the importance of autopsies to ensure high quality in diagnostics and therapy not only in the field of oncology.

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Section: Discussionsupporting

confidence: 94%

Section: Introductionsupporting

confidence: 93%

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Can low autopsy rates be increased? Yes, we can! Should postmortem examinations in oncology be performed? Yes, we should! A postmortem analysis of oncological cases

Waidhauser¹,

Martin²,

Trepel³

et al. 2020

Virchows Arch

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“…S obzirom na to da je veliki broj pacijenata imao hroničnu ishemijsku bolest srca, ovakav rezultat se mogao očekivati. Naš rezultat je sličan rezultatima drugih autora [1,5,6]. Međutim, u slučajevima kada se radi o naprasnoj smrti, učestalost srčanih uzroka smrti je veća od 50% [7,8].…”

Section: Diskusijaunclassified

Cause of death during the first 24 hours after hospitalization: An autopsy study

Janković¹,

Jordanova²,

Jevtić³

et al. 2020

Halo 194

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Introduction/Objective Postmortem examination has a significant role in evaluating the quality of health care. The objective of the paper is to analyze the cause of death as determined by postmortem examination in patients who had undergone emergency hospitalization and had subsequently died within 24h, as well as the factors that contributed to the fatal outcome and correlation with available clinical data. Methods the analysis included autopsy reports and protocols, as well as clinical data from medical records and autopsy referrals during the three year period (2018-2020) for patients who had undergone a postmortem examination at the Insitute of Pathology, Medical Faculty, University of Belgrade. The correlation between the clinical diagnosis and postmortem findings was evaluated using Goldman criteria. Results the patients analysed were predominantly male (52/90; 58%). Women were statistically significantly older than men (p=0.024). The most common clinical diagnosis was cardiovascular disease (32.2%). The majority of the patients reported experiencing the first symptoms a few hours before seeking medical help (80%). The majority of the patients were being treated for chronic disease (80%) before hospitalization. The immediate cause of death determined by postmortem examination was most commonly heart failure (38/90, 42.2%). The most common clinically unrecognised causes of death include: bronchopneumonia (8/90), myocarditis (3/90), acute ischemic lesion/acute myocardial infarction (3/90) and bowel infarction (3/90). Conclusion the correlation between clinical and postmortem findings is very important because it enables the discovery of diagnostic and treatment errors and promotes new knowledge crucial for medical advancement.

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“…The current study showed declining autopsy rates over the years. Several causes for the decline have been identified, the most important being few physicians requesting for autopsy nowadays,26 difficulty in obtaining consent from relatives of deceased patients,27 and use of radiological imaging techniques as substitution for autopsy 28,29. Theoretically, this could result in selection bias, because of a more predominant selection of patients with an unexpected death or without a clear cause of death.…”

mentioning

confidence: 99%