The results of autopsy of patients with surgical diseases of the digestive tract.
The results of autopsy of 77 patients who died because of surgical disease of the digestive tract were compared with antemortem findings. An analysis was performed to identify missed diagnoses and incorrect therapy. Primary diagnoses had not been frequently missed, but many complications of the primary disorder or treatment had been overlooked. Many patients died because of septic conditions. Error in treatment, with an adverse impact on the course of the disease as assessed by the postmortem examination, occurred in 9 percent of the patients. The most common error had been failure to reoperate upon patients with an intra-abdominal complication. Unexpected death was significantly associated with incorrect diagnosis; failed or inadequate diagnostic methods were significantly associated with treatment failure (chi-square tests). The autopsy remains a valuable procedure in clinical operation. Selection of patients for autopsy, as indicated by decreasing autopsy rates, is not justified.
Barendregt
W B
WB
Department of General Surgery, University Hospital Nijmegen, The Netherlands.
de Boer
H H
HH
Kubat
K
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy / Q000706:statistics & numerical data*; D002423:Cause of Death; D002985:Clinical Protocols / Q000592:standards; D003951:Diagnostic Errors; D004066:Digestive System Diseases / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007239:Infections / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012086:Reoperation / Q000706:statistics & numerical data