Relevance of Autopsy As a Diagnostic Tool in Present Times: A Study
Keywords:
Autopsy, Cause of death
Abstract
BACKGROUND: Autopsy rates have been declining world-wide; the ever-increasing availability of advanced diagnostic tests, complex legal procedure, and fear of medico-legal lawsuits appear to be some of the contributing factors. Clinical judgment errors however have shown no decline and continue to remain a source of concern. Mortality and morbidity data statistics become relevant in framing health policies only when validated by corresponding autopsy studies. The present study was conducted to ascertain the utility of autopsy as a modern diagnostic tool.METHODS: A prospective study of hundred consecutive cases of medico-legal autopsies received in the Pathology Department was carried out for their demographic characteristics with a comparative analysis between the initial cause of death and final autopsy diagnosis. The utility of autopsy in discovering hitherto unknown incidental pathologies was also evaluated.RESULTS: In 17.6 % of cases, the final cause of death was revealed only after autopsy. It proved especially beneficial in discovering latent cardiac illnesses, occult visceral bleed sites, and undiagnosed respiratory and infectious pathologies. Hitherto unknown incidental findings which were not directly responsible for death but nevertheless enhance our understanding of different pathologic processes were found in 16.5 % of cases.CONCLUSION: The study confirmed the utility of autopsy as an important diagnostic tool in revealing the true cause of death and contributing to our understanding of evolution of different disease processes. Simplifying the legal procedure will encourage more autopsies, stirring the clinician’s interest and involvement in autopsy studies.References
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2. Ermenc B .Comparison of the clinical and postmortem diagnoses of the causes of death. Forensic Sci Int 2000; 114:117-119.
3. Cordazzi AL, Morganti ALC, Montenegro MRG.Discrepancies between clinical diagnosis and autopsy findings. Braz J Med Biol Res 2003; 36: 385-391.
4. Sonderegger- Iseli K, Burger S, Muntwyler J, Salomon F. Diagnostic errors in three medical eras: a necropsy study. Lancet 2000; 355:2027-2031.
5. Baron JH .Clinical diagnosis and the function of necropsy.J R Soc Med 2000; 93:463-466.
6. Esteban A, Fernandez -Segoviano P.The autopsy as a tool to monitor diagnostic error.Intensive Care Med 1999; 25(4):343-344.
7. Kirch W, Schaffi C. Misdiagnosis at a university hospital in 4 medical eras.Medicine 1996; 75:29-40.
8. Goldman L, Sayson R, Robbin S, Cohn LH, Bettmann M, Weisberg M.The value of autopsy in three medical eras. N Engl J Med 1983; 308:1000-1005.
9. Ludwig J. Handbook of Autopsy Practice.3 ed. Towata, New Jersey:Humana Press ; 2002.
10. Patel S,Rajalakshmi BR, Manjunath GV.Histopathologic findings in autopsies with interesting and incidental findings. Journal of Clinical and Diagnostic Research 2016; 10(11):EC08-EC12.
11. Mangal K , Dhakar P, Yadav A, Gupta K, Gandhi S. Magnitude of pulmonary diseases –Incidentally diagnosed on autopsy-at largest hospital and medical college of Rajasthan. International Journal of Current Research and Review 2016; 8(4):37-43.
12. Shojania KG, Burton EC, Mc Donald KM, Goldman L.The autopsy as an outcome and performance measure. Rockville (MD): Agency for Healthcare Research and Quality (US) 2002; 58:1998-2005.
13. Borson S, Randall Curtis J. Examining the link between sarcoidosis and depression. Am J Respir Crit Care Med 2001; 163 (2):306-308.
14. Soiero AM, Ruppert AD, Canzian M ,Capelozzi VL, Serrano CV.Postmortem diagnosis of acute myocardial infarction in patients with acute respiratory failure - demographics , etiologic and pulmonary histologic analysis.Clinics 2012; 67(3):213-217.
15. Fischer EG, Marek JM, Morris A, Nashelsky MB .Cholesterol Granulomas of the Lung. Arch Pathol Lab Med 2000; 124:1813-1815.
16. Hill RB, Anderson RE.The autopsy - medical practice and public policy. Stoneham, MA:Butterworths Publishers;1988
Published
18-12-2017
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