Correlation between clinical diagnoses and autopsy findings in critically ill children.
OBJECTIVE
To examine the correlation between clinical diagnoses and autopsy findings in children who die in the pediatric intensive care unit (PICU).


METHODS
Retrospective chart review.


METHODS
PICU of a university-affiliated hospital.


METHODS
A consecutive sample of patients who died in the PICU and had autopsies performed.


RESULTS
Of 193 patients who died during the 7 1/2-year study period, 50 (26%) had autopsies performed. The mean age was 34.7 months (range 15 hours to 17 years), and the mean length of stay in the PICU was 12.2 days (range 2 hours to 60 days). Major admitting diagnoses included postoperative cardiac surgery (19), nonoperative cardiac disease (7), hematologic/malignant disorder (5), and acquired immunodeficiency syndrome (5). There were 5 cases (10%) where autopsy revealed a major finding that, if known prior to death, would have altered clinical management and might have resulted in cure or prolonged survival. In another 9 patients (18%) the autopsy revealed major findings that, if known prior to death, would not have altered management. Eight of these findings related to the cause of death and 2 of them involved the basic disease. There was no correlation between new findings and either patient age or length of stay in the PICU.


CONCLUSIONS
Despite modern diagnostic techniques, the autopsy continues to reveal valuable and unsuspected information.
Stambouly
J J
JJ
Department of Pediatrics, North Shore University Hospital-Cornell University Medical College, Manhasset, NY 11030.
Kahn
E
E
Boxer
R A
RA
D000293:Adolescent; D001344:Autopsy; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness; D003933:Diagnosis; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007902:Length of Stay; D008297:Male; D012189:Retrospective Studies