Trends in prevalence of fatal surgical diseases at forensic autopsy.
BACKGROUND
In 1992, there were major changes in Swedish law of the deceased, which had led to a dramatic decrease in autopsy rates. The aim of this study was to investigate the prevalence of fatal or potential fatal surgical diseases within a Swedish forensic autopsy cohort, before and after this change in legislation.


METHODS
Deaths referred for forensic autopsy at the Institution of Forensic Medicine, Lund University Hospital, Sweden, between 1970-1982 and 2000-2004, were studied regarding the prevalence of aorto-iliac diseases, acute abdomen and abdominal cancer.


RESULTS
The forensic autopsy rates in the population during the two time periods were 14.0% (29 399 patients) and 5.3% (4487 patients), respectively. The total prevalence of surgical diseases has increased significantly from 67.3 (95% confidence interval 64.3-70.2) to 83.4 (74.9-91.8) per 1000 autopsies, respectively. The cause-specific mortality ratios in patients with fatal acute abdomen increased significantly from 16.5 (15.1-18.0) to 39.0 (33.2-44.8) per 1000 autopsies, respectively, and there was almost a three-time increase in patients with fatal gastrointestinal haemorrhage and acute alcohol-related pancreatitis.


CONCLUSIONS
Forensic autopsy data continues to be invaluable, despite changes in legislation in Sweden, for epidemiological studies on fatal or potential fatal surgical diseases.
Acosta
Stefan
S
Department of Vascular Diseases, Malmö University Hospital, S-205 02 Malmö, Sweden. stefan.acosta@telia.com
Krantz
Peter
P
D000006:Abdomen, Acute / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D000008:Abdominal Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D000783:Aneurysm / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D001014:Aortic Aneurysm / Q000453:epidemiology / Q000401:mortality / Q000473:pathology; D001344:Autopsy / Q000706:statistics & numerical data*; D006801:Humans; D017543:Iliac Aneurysm / Q000453:epidemiology / Q000401:mortality / Q000473:pathology; D015995:Prevalence; D013548:Sweden / Q000453:epidemiology