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.
Department of Vascular Diseases, Malmö University Hospital, S-205 02 Malmö, Sweden. stefan.acosta@telia.com
Stefan
S
Acosta
Peter
P
Krantz
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