title: The clinical diagnostic accuracy rate regarding the immediate cause of death in a hospitalized geriatric population; an autopsy study of 1594 patients.
abstract: BACKGROUND
  In the geriatric population the autopsy rate is low, leading to mortality statistics often based on clinical diagnoses alone.
  
  
  OBJECTIVE
  To determine the clinical diagnostic accuracy rate regarding the immediate cause of death (CDARCD), the number of major underlying diseases and sole diagnoses, and general data about the immediate cause of death in geriatric hospitalized patients.
  
  
  METHODS
  The autopsy proven immediate cause of death was compared with the clinical diagnosis in 1594 patients over 69 years of age. Based on the autopsy protocols, the mean number of major underlying diseases and sole diagnoses were calculated. The immediate cause of death was classified into six groups: cardiovascular disease (CVD), malignant neoplasms (MN), bronchopulmonary disease (BPD), fatal pulmonary embolism (PE), miscellaneous (M), and marantic atrophy (MA).
  
  
  RESULTS
  The overall CDARCD was 52.5%, being highest in MN (65.0%), followed by CVD (56.0%), MA (50%), BPD (48.3%), M (44.3%), and PE (26.7%). The most common cause of death was CVD (35.8%), followed by MN (24.3%), BPD (19.8%), PE (10.6%), M (7.7%) and MA (1.9%). The mean number of major underlying diseases and sole diagnoses was 2.0 and 14.4 respectively.
  
  
  CONCLUSIONS
  The low CDARCD in our study strongly indicates the need for autopsy when reliable mortality statistics are desired.
authors.affiliation: Pathologic-Bacteriologic Institute, SMZ Otto Wagner Hospital, Vienna, Austria. johannes.attems@wienkav.at
authors.forename: Johannes
authors.initials: J
authors.lastname: Attems
authors.forename: Stephanie
authors.initials: S
authors.lastname: Arbes
authors.forename: Gerhard
authors.initials: G
authors.lastname: Böhm
authors.forename: Franz
authors.initials: F
authors.lastname: Böhmer
authors.forename: Felix
authors.initials: F
authors.lastname: Lintner
mesh_terms: D000368:Aged; D001317:Austria; D001344:Autopsy / Q000706:statistics & numerical data; D002423:Cause of Death; D002908:Chronic Disease / Q000401:mortality*; D003951:Diagnostic Errors / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male