title: Incidence of autopsy findings in unexpected deaths of children and adolescents.
abstract: 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.
authors.affiliation: Department of Pediatric Pathology, Slot 820, Arkansas Children's Hospital, 800 Marshall Street, Little Rock, AR 72202, USA. parhamdavidm@uams.edu
authors.forename: David M
authors.initials: DM
authors.lastname: Parham
authors.forename: Van H
authors.initials: VH
authors.lastname: Savell
authors.forename: Charles P
authors.initials: CP
authors.lastname: Kokes
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Erickson
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Peretti
authors.forename: James B
authors.initials: JB
authors.lastname: Gibson
authors.forename: William Q
authors.initials: WQ
authors.lastname: Sturner
mesh_terms: 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