Referral for autopsies: analysis of 651 consecutive deaths in one general practice

Abstract

Autopsies represent a key instrument in educating doctors and may aid quality assurance for primary and secondary care. This study shows that only a few patients have an autopsy, of which the majority are carried out at the request of the coroner for medicolegal reasons. Better education and communication between general practitioners, hospital clinicians, pathologists, and coroners may increase the rate of autopsies. (Postgrad Med J 2000;76:415-416)

Autopsy in older medical patients: concordance in ante- and post-mortem findings and changing trends

“…There has been a rapid decline in hospital post mortems and the majority of autopsies are now Coroner's post mortems. [17][18][19] The higher post-mortem rate in our study reflects the local practice, as Coroners differ in their thresholds for requesting post mortems. Post-mortem examinations as a part of a Coroner's enquiry are being increasingly recommended.…”

“…17 Another study from primary care showed a post-mortem rate of 11.7% from 651 deaths over a four-year period. 18 While every hospital or community death most certainly does not require post-mortem verification, the singular cause for a decline in post mortems is due to a massive decline in clinical hospital post mortems. In one study hospital post mortems had fallen from 25.8% in 1979 to 3.9% in 2001, while Coroner's post-mortems had only fallen from 16.8% to 11.4%.…”

Making use of mortality data to improve quality and safety in general practice: a review of current approaches

“…38 One team reported use of the information to investigate nursing involvement in terminal care at home, 39 three others to investigate place of death, [40][41][42] three more potentially preventable deaths, [43][44][45] and others age at death and smoking 46 and referrals for autopsy. 47 In another practice, information was sought about the involvement of the general practitioner in the care of patients before death. 48 In the only study to attempt to directly relate clinical practice to mortality, the collection of information about deaths and clinical performance over 25 years enabled the practice to reflect on the impact of its activities in comparison with other practices.…”

Referral for autopsies

“…Editor, —With reference to the paper by Khunti last July,1 the aim should not be to increase the number of autopsies, but rather to increase their specificity as a research tool to be of benefit in three ways where the cause of death is unclear: educating the profession, ascertaining where death is unnatural, and most importantly facilitating the grieving process of relatives. In all three situations feedback should be given to the relatives as the author suggests because knowledge of the cause of death is important.…”