[The role of clinical autopsy in monitoring the quality of the clinical diagnosis in an emergency department].
OBJECTIVE
A total of 61 autopsies performed in patients died in emergency department of a university hospital were retrospectively analysed and the findings were compared with clinical diagnoses.


METHODS
Sensitivity and specificity of the clinical diagnoses and the correction of medical procedures were measured. The influence of age and sex of patients was analyzed using Fisher's exact test and chi-square-test.


RESULTS
The most common causes of death were cardiovascular diseases (52.46%). Autopsy showed unexpected major findings in 44.26% of cases. Major discrepancies between the autopsy reports and the clinical diagnoses, were present in 26.22% of all cases. Absolute concordance between clinical and autopsy diagnoses was obtained in 44.26% of cases. The major sensitivity of clinical diagnosis was found in cerebrovascular disorders (100%), upper digestive hemorrhage (100%), and acute myocardial infarction (82.35%). The lowest sensitivity was found in malignant tumors (16.66%), hemorrhagic pancreatitis (0%) and bowel infarction (0%). The patient cares were correct in 68.85% of cases. No statistically significant differences were observed in relation to age and sex.


CONCLUSIONS
We concluded that autopsy is a useful method for evaluate diagnostic procedures and quality of medical cares in emergency departments.
Balaguer Martínez
J V
JV
Unidad de urgencias, Hospital Clinic Universitari de Valencia.
Gabriel Botella
F
F
Braso Aznar
J V
JV
Núñez Sánchez
C
C
Catalá Barceló
T
T
Labios Gómez
M
M
D000328:Adult; D000368:Aged; D001344:Autopsy; D004636:Emergency Service, Hospital / Q000592:standards*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D019300:Medical Errors; D008875:Middle Aged; D011787:Quality of Health Care; D012189:Retrospective Studies; D013030:Spain
El papel de la autopsia clínica en el control de calidad de los diagnósticos clínicos en una unidad de urgencias.