Hospital autopsies: still valuable in their traditional role but in need of reform.
In 1997, 158 autopsies were performed at Charleston Area Medical Center, a community-based, teaching tertiary care center. The autopsies revealed 29 (18.4%) clinically undiagnosed principal causes of death, of which 79% were considered treatable. The five leading undiagnosed causes were: infarctions, 27.6%; malignant neoplasms, 17.2%; pulmonary emboli, 13.8%; dissecting or ruptured aortic aneurysms, 13.8%; and genetic or congenital disorders 10.2%. These results were significantly different from those reported from some other major tertiary care centers. Reports were completed in 5-302 days (average 59, median 32 days). For more than 40 (25%) of these autopsies, the purpose was only to confirm specific disorders such as occupational injury, which can be accomplished by a highly selective, cost-effective posthumous analysis. In summary, an autopsy in today's high-technology era is still useful, however, the high cost, long length of reporting time, and number of clinically non-enlightening cases are a reasons to reform both the format and procedure in which these procedures are conducted.
Zhang
J R
JR
Dept. of Pathology, Harbor-UCLA Medical Center, Torrence, USA.
Shenoy
V
V
Mangano
W E
WE
Chang
H H
HH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy / Q000191:economics / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged