[Correlation of autopsy findings with the clinical diagnosis in common diseases of the circulatory system in a general hospital].
In a group of 1100 autopsies made in 1987-1989 the author correlates the clinical and autoptic diagnosis of embolism of the pulmonary artery, acute myocardial infarction, valvular defects, chronic cor pulmonale, cardiomyopathies, cerebrovascular attacks, subarachnoid haemorrhage; the latter was compared with the diagnosis of chronic subdural haematoma. The sensitivity of the clinical diagnosis of some diseases is low, in different categories 10-80% of diseases escape the clinical diagnosis. As compared with correlations of clinical and pathological findings published abroad, the standard of diagnosis of embolism of the pulmonary artery is roughly the same (some 80% controversial clinical and autoptic diagnoses), in acute infarction it is worse (some 50% controversial diagnoses), in acute cerebrovascular attacks it is worse only when compared with some (cca 25-40% controversial diagnoses according to the categories of the international classification). Evaluation of the sensitivity and specificity of the clinical diagnosis is only orientational, more important is the frequency of diagnostic controversies with regard to severity. Errors of the first type, i.e. those where knowledge of the autoptic diagnosis before death would have most probably influenced the therapy and prognosis is in embolism of the pulmonary artery and myocardial infarction 10 and 13% resp., in the other categories errors are rare or absent, there are, however, frequent errors in the diagnosis of subdural haematoma.
Koukolík
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Oddĕlení patologie fakultní Thomayerovy nemocnice, Praha.
D001344:Autopsy; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000473:pathology; D003951:Diagnostic Errors; D006769:Hospitals, General; D006801:Humans
Autoptická korelace klinické diagnostiky castých onemocnĕní obĕhového systému v praxi vseobecné nemocnice.