Postoperative Death Should Be Followed by Autopsy - an Analysis of the Autopsy Findings of the Years 1990 and 1991 in a Heart Surgery Center

Deiwick, M.; Löhrer, A; Hoffmeier, A; Ha, Baba; Böcker, Wolfgang; Hh, Scheld

doi:10.1055/s-2007-1013116

Cited by 15 publications

(17 citation statements)

References 12 publications

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“…Despite extensive investigations in this field since the introduction of CABG in the late 1960s, only relatively few clinicopathological studies on causes of death and complications have yet been reported [6,16,18,29]. This may partly be explained by the fact that in the last decades the autopsy rate has shown continual declination in the western world.…”

Section: Discussionmentioning

confidence: 99%

“…Still, postmortem examination is acknowledged as one of the most specific indicators of errors in diagnosis, management, judgment, and technique in surgery. Therefore, it is an invaluable means of quality assurance in clinical practice in general and especially in heart surgery [6]. A prospective study by Lee et al [16] found cardiac failure to be the most common cause of death (52%), the preoperative acute myocardial infarction being the most important predisposing factor.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Mechanisms of death in the early postoperative period following coronary artery bypass grafting for acquired heart disease. A clinicopathological study of 32 cases

Glasz

Frenken²,

Knieriem

et al. 2003

Virchows Archiv

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Mechanisms of death in the early postoperative period following coronary artery bypass grafting for acquired heart disease. A clinicopathological study of 32 cases

Glasz

Frenken²,

Knieriem

et al. 2003

Virchows Archiv

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show abstract

“…There was a relatively high discrepancy (30%) between clinical and autopsy findings in these patients. Other studies report discrepancy rates varying from 15% to 60%, depending on the population under investigation [16][17][18]. In our selected group of patients admitted with a proximal femoral fracture, we found a low discrepancy rate of 7%.…”

Section: Discussionmentioning

confidence: 39%

Mortality Registration in Patients with a Proximal Femoral Fracture Admitted to a Surgical Ward

Tjeenk¹,

Schepers²,

Linde³

et al. 2002

Eur J Trauma

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“…Five centres have reported their findings [9][10][11][12][13] and these are summarised in table 2. Although the pattern of surgery and the post mortem rate differed, there were some consistent findings.…”

Section: What Has Been Learnt From Autopsies Performed On Patients Dymentioning

confidence: 99%

Post mortem examinations after cardiac surgery

Hickling

Pontefract

Gallagher³

et al. 2007

Heart

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A t present in England and Wales just over 20% of all deaths are followed by a post mortem examination, almost all on the instructions of a coroner. In contrast, in Scotland and Northern Ireland the rates are below 10%. In a wider context overall post mortem rates in the provinces of Canada vary between 5-9% and are probably much lower in France and Germany. The reasons for this variation are unknown. Remarkably there has been no national audit of the indications for, or value of, autopsy examination. In this review we consider: c why autopsies should be performed after cardiac surgery c who should perform these autopsies and how they should be reported c what has been learnt from post mortem examinations performed on patients dying after cardiac surgery c what the role of these autopsies is in the future. POST MORTEM EXAMINATION AFTER SURGERY cPathologists frequently refer to the many published studies which have shown that important new information is detected in autopsies performed in patients dying in hospital.1 At least two have shown that the rate of unexpected findings has not altered significantly over several decades. Methods have been developed to categorise the degree of concordance between pre-mortem clinical diagnoses and post mortem findings.2 A recent meta-analysis identified discrepancies in 10-20.6% of post mortem examinations where the patient would potentially have survived if the correct diagnosis had been known in life. 4 Although most of these studies have included patients dying after surgery, there have been few that specifically studied the value of post mortem examination after surgery. A retrospective study from Connecticut studied the clinical records and post mortem reports of 150 patients who died in a surgical intensive care unit. There was full agreement in only 58% of cases. The longer the patient was in the unit the greater the chance was of an unexpected finding. Infection was the most common undiagnosed condition, especially in patients who had received a transplant. 6 Impressed by these findings, we made a similar audit of 92 patients dying in our hospital after surgery in 2002 who had an autopsy. We found full agreement in 65%, a major disagreement in 20% and less important discrepancies in 15% of cases. Infection, pulmonary thromboembolism and ischaemic heart disease were the most important conditions diagnosed at post mortem examination. Important discrepancies were identified in 33% of orthopaedic procedures, 31% of neurosurgical, 27% of general surgical operations, but only 5.7% of cardiac operations.

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Postoperative Death Should Be Followed by Autopsy - an Analysis of the Autopsy Findings of the Years 1990 and 1991 in a Heart Surgery Center

Cited by 15 publications

References 12 publications

Mechanisms of death in the early postoperative period following coronary artery bypass grafting for acquired heart disease. A clinicopathological study of 32 cases

Mechanisms of death in the early postoperative period following coronary artery bypass grafting for acquired heart disease. A clinicopathological study of 32 cases

Mortality Registration in Patients with a Proximal Femoral Fracture Admitted to a Surgical Ward

Post mortem examinations after cardiac surgery

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