Incidence of autopsy findings in unexpected deaths of children and adolescents.
Studies in various settings reveal that a significant percentage of autopsies demonstrate findings that were not previously clinically diagnosed. In the pediatric and adolescent age group, forensic examinations comprise a large percentage of total autopsies performed. We hypothesized that a similar number of previously undiagnosed findings would be present in this population and thus reviewed a series of autopsy reports from the Medical Examiners Office in the Arkansas Crime Laboratory. During 1997 through 1999, we performed 439 complete forensic autopsies on children and adolescents (age range 1 day to 19 years; median 18 months). Previously undiagnosed lesions were found in 173 (39%). Of these subjects, 68 (39%) had clinically significant pathology, 60 (35%) had insignificant pathology, and 45 (26%) had pathology of undetermined significance. Thirty-six subjects had lesions expected from a previously diagnosed condition. Of the total number of lesions found, 168 were inflammatory, 58 were congenital anomalies (48 unexpected), and 88 comprised miscellaneous other conditions. Infants <6 months of age were significantly more likely to have a previously undiagnosed lesson than children > 6 months (P <0.0001). Previously undiagnosed findings, mostly inflammatory, occur relatively frequently in pediatric and adolescent forensic autopsies and are more likely to occur in infants.
Parham
David M
DM
Department of Pediatric Pathology, Slot 820, Arkansas Children's Hospital, 800 Marshall Street, Little Rock, AR 72202, USA. parhamdavidm@uams.edu
Savell
Van H
VH
Kokes
Charles P
CP
Erickson
Stephen A
SA
Peretti
Frank J
FJ
Gibson
James B
JB
Sturner
William Q
WQ
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D003645:Death, Sudden / Q000209:etiology*; D005554:Forensic Medicine; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D010336:Pathology; D010372:Pediatrics; D012189:Retrospective Studies