Impact of BMI on clinically significant unsuspected findings as determined at postmortem examination.
We conducted a retrospective cohort study based on autopsy reports of 311 patients who underwent full postmortem examinations from January 1, 1999, to December 31, 2002. Clinically unsuspected diagnoses were categorized as follows: class I, major clinically unsuspected diagnoses that were responsible for death; class II, major clinically unsuspected diagnoses that were not directly responsible for death but if left undiagnosed may have resulted in patient death; and class V, no clinically unsuspected diagnoses. Two multivariate analyses were performed using 4 variables to predict class I diagnoses. Both analyses included the variables sex, race, and age; the fourth variable included umbilicus pannus size or body mass index (BMI). Only BMI (P = .006) and umbilicus pannus size (P = .037) were independent predictors of class I diagnoses. Obese patients were 1.65 times more likely (relative risk, 1.65) to have a class I diagnosis than the normal weight and underweight groups combined (confidence interval, 1.04-2.64). Patients with obese-level BMIs seem to be at increased risk for clinically significant unsuspected diagnoses compared with underweight and normal weight populations.
Department of Pathology, Drexel University College of Medicine, Philadelphia, PA 19129, USA.
Simon
S
Gabriel
Edward J
EJ
Gracely
Billie S
BS
Fyfe
D050153:Abdominal Fat / Q000473:pathology; D000368:Aged; D001344:Autopsy / Q000706:statistics & numerical data; D015992:Body Mass Index; D002423:Cause of Death; D015331:Cohort Studies; D003951:Diagnostic Errors / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications; D015143:Philadelphia / Q000453:epidemiology; D012189:Retrospective Studies; D014472:Umbilicus / Q000473:pathology