Abstract
A retrospective study of the autopsy rate of the clinico-pathological correlations was made in a group of inpatients. The trend of autopsy rate was observed in all impatients died in a university hospital during a nine year period (from 1975 to 1983). The agreement between the clinical and pathological death diagnosis was retrospectively controlled in 294 consecutive patients died and submitted to autopsy in the same hospital during a 6 month period (from January to June 1983).
The results show that: 1) In the oldest (> 60 yrs) patients, the autopsy rate trend was significantly reduced from 1975 to 1983, whereas the hospital admissions and the mortality rate increased. 2) In the youngest subjects (< 60 yrs), the autopsy rate trend, the hospital admissions and the mortality rate did not significantly change from 1975 to 1983. 3) In all the years considered, the autopsy rate was significantly reduced in the oldest class (p > 0.01). 4) The agreement between the clinical and pathological diagnosis was observed in 83% of cases in the < 60 years class and in 63°% of cases in the > 60 yrs class (p > 0.001). 5) The association of main disease with other diseases was significantly more frequent in the > 60 yrs class with respect to the < 60 yrs class (p < 0.01).
It has been concluded that the autopsy, expecially in the elderly, is absolutely necessary for a better quality control of the clinical diagnosis and of the medical care.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Ahronheim J., Bernholc A., Clark W. (1983): Age trends in autopsy rate. J.A.M.A., 250: 1182–1186.
Armitage P. (1971): Statistical methods in medical research. - Blackwell Scientific Publications, London.
Asnaes S., Frederiksen V., Fenger C. (1983): The value of the hospital autopsy. A study of causes and modes of death estimated before and after autopsy. - Forensic Sci. Int. 21: 23–32.
Britton M. (1974): Diagnostic errors discovered at autopsy. - Acta med. scand., 196: 203–210.
Cameron H., McGoogan E., Clarke J., Wilson B. (1977): Trends in hospital necropsy rates: Scotland 1961–74. - Br. Med. J., 1: 1577–1580.
Cameron H., McGoogan E., Watson H. (1980): Necropsy: a yardstick for clinical diagnoses. -Br. Med. J., 281: 985–988.
Cameron H., McGoogan E. (1981): A prospective study of 1152 hospital autopsies: I. Inaccuracies in death certification. - J. Pathology, 133: 273–283.
Dina M.A., Allegri C. (1970): Confronto anatomoclinico sui primi mille riscontri diagnostici eseguiti nel settorato della Facoltà di Medicina e Chirurgia. - Acta Medica Romana, VII: 201–211.
Engel L., Strauchen J., Chiazze L. Jr., Heid M. (1980): Accuracy of death certification in an autopsied population with specific attention to malignant neoplasms and vascular diseases. -Am. J. Epidemiol., 111: 99–112.
Gambino S. (1984): The autopsy. Arch. Pathol. Lab. Med., 108: 444–445.
Goldman L., Sayson R., Robbins S., Cohn L.H., Bettman M., Weisberg M. (1983): The value of the autopsy in three medical eras. - N. Engl. J. Med., 308: 1000–1005.
King D. (1984): Potential of the autopsy. - Arch. Pathol. Lab. Med., 108: 439–443.
Lowe J., Davis C. (1977): Need we revive falling autopsy rates?: time trends in P.A.S. hospitals in the United States. - P.A.S. Rep., 15: 1–7.
Lundberg G. (1984): Medicine %vithout the autopsy. Arch. Pathol. Lab. Med., 108: 449–454.
Pounder D.J., Rowland R., Horowitz M., Reid D.P. (1983): The value of the autopsy in medical audit — A combined clinical and pathological assessment of 100 cases. Aust. N.Z.J. Med., 13: 478–482.
Roberts W.C. (1978): The autopsy: its decline and a suggestion for its revival. - N. Engl. J. Med., 299: 332–338.
Schottenfeld D., Eaton M., Sommers S.C., Alonso D.R., Wilkinson C. (1982): The autopsy as measure of accuracy of the death certificate. - Bull. N.Y. Acad. Med., 58: 778–793.
Scottolini A.G., Weinstein S.R. (1983): The autopsy in clinical quality control. - J.A.M.A. 250: 1192–1194.
Waldron H.A., Vickerstaff L. (1975): Necropsy rates in the United Birmingham Hospitals. - Br. Med. J., 2: 326–328.
Walsh C.J. (1974): Autopsy rates in U.S. hospitals.- P.A.S. Rep., 12: 1–4.
W.H.O. (1981): International Classification of Diseases. - IX Revision. - Geneva.
Author information
Authors and Affiliations
Additional information
Corresponding author.
Rights and permissions
About this article
Cite this article
Cocchi, A., Vecchio, F.M., Pahor, M. et al. Autopsy rate in younger and older hospitalized patients. Eur J Epidemiol 2, 151–157 (1986). https://doi.org/10.1007/BF00157027
Issue Date:
DOI: https://doi.org/10.1007/BF00157027