F Erlmeier1, W Weichert2,3, R Knüchel4, J Andruszkow4. 1. Institut für Pathologie, Technische Universität München, Trogerstr. 18, 81675, München, Deutschland. f.erlmeier@tum.de. 2. Institut für Pathologie, Technische Universität München, Trogerstr. 18, 81675, München, Deutschland. 3. Deutsches Konsortium für Translationale Krebsforschung, Heidelberg, Deutschland. 4. Institut für Pathologie, Universitätsklinikum der RWTH Aachen, Aachen, Deutschland.
Abstract
BACKGROUND: The clinical autopsy is the ultimate medical service for a patient and plays a crucial role in the education of physicians and other medical personnel, as well as in the context of quality control. Nevertheless, the number of autopsies is constantly decreasing. Numerous factors, such as the personal attitude of relatives and also clarification of relatives, as well as the increasing application of imaging methods while the patient is still alive, play a central role in this decline. OBJECTIVE: This study aimed to demonstrate the development of autopsy services over the past decade in two university hospitals in Germany and therefore to underline the importance of this investigation procedure in pathology. MATERIAL AND METHODS: Autopsy reports between the years 2005 and 2014 from 2 university institutes of pathology were analyzed regarding a diverse dataset, including age and sex of the deceased as well as the clinical and pathological causes of death. RESULTS: The data showed that the number of autopsies has continuously decreased over the past decade; however, the distribution of characteristics of the deceased remained relatively stable. In this cohort the clinically assumed cause of death differed from the pathological cause of death in 6% of the autopsies. Frequently occurring discrepant diagnoses were cardiac tamponade, aortic dissection and endocarditis/myocarditis. DISCUSSION: Our results show that, despite significant improvements in imaging methods, findings do not yield more accurate results than does autopsy. This underscores once again the need to encourage the performance of this final medical act on patients.
BACKGROUND: The clinical autopsy is the ultimate medical service for a patient and plays a crucial role in the education of physicians and other medical personnel, as well as in the context of quality control. Nevertheless, the number of autopsies is constantly decreasing. Numerous factors, such as the personal attitude of relatives and also clarification of relatives, as well as the increasing application of imaging methods while the patient is still alive, play a central role in this decline. OBJECTIVE: This study aimed to demonstrate the development of autopsy services over the past decade in two university hospitals in Germany and therefore to underline the importance of this investigation procedure in pathology. MATERIAL AND METHODS: Autopsy reports between the years 2005 and 2014 from 2 university institutes of pathology were analyzed regarding a diverse dataset, including age and sex of the deceased as well as the clinical and pathological causes of death. RESULTS: The data showed that the number of autopsies has continuously decreased over the past decade; however, the distribution of characteristics of the deceased remained relatively stable. In this cohort the clinically assumed cause of death differed from the pathological cause of death in 6% of the autopsies. Frequently occurring discrepant diagnoses were cardiac tamponade, aortic dissection and endocarditis/myocarditis. DISCUSSION: Our results show that, despite significant improvements in imaging methods, findings do not yield more accurate results than does autopsy. This underscores once again the need to encourage the performance of this final medical act on patients.
Entities:
Keywords:
Autopsy; Decreasing autopsy frequency; Development; Imaging method; Quality control
Authors: T Hansen; S Höring; F Rosendahl; M Dusolt; C Kempe; M Hechtner; C Sommer; C J Kirkpatrick Journal: Pathologe Date: 2014-07 Impact factor: 1.011