title: The value of post mortems in cardiac surgery: learning from the dead.
abstract: BACKGROUND
  Little information is available regarding the role of post-mortem in cardiac surgery. The cause of death by clinical presumption can be misleading. The aim is evaluate the role of post-mortem following cardiac surgery by comparing clinically attributed causes of death versus post-mortem findings.
  
  
  METHODS
  A total of 10,099 cardiac operations were performed over a seven-year period in a single institution in the United Kingdom. There were 363 (3.6%) deaths. The mean age at death was 71 with 66.7% male. Of these, 348 (95.9%) patients underwent a post-mortem examination.
  
  
  RESULTS
  There was a significant disparity between presumed and actual causes of death in 78 (22.4%) patients. The commonest unrecognised cause of death was cardiac causes (21 patients, 6.0%). The most overestimated cause of death was multi-organ failure, which was incorrectly diagnosed as the cause of death in 28 patients (8.0%).
  
  
  CONCLUSIONS
  Post-mortem can determine unsuspected diagnoses in a significant proportion of patients undergoing cardiac surgery. It plays an important role in cardiac surgery and remains essential for quality assessment in perioperative treatment.
authors.affiliation: Oxford Heart Centre, John Radcliffe Hospital, Oxford, United Kingdom. ravidesilva@nhs.net
authors.forename: Ravi J
authors.initials: RJ
authors.lastname: De Silva
authors.forename: P
authors.initials: P
authors.lastname: Bhinda
authors.forename: M
authors.initials: M
authors.lastname: Goddard
authors.forename: Cliff K
authors.initials: CK
authors.lastname: Choong
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures / Q000379:methods / Q000401:mortality / Q000706:statistics & numerical data*; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D002423:Cause of Death; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors; D006113:United Kingdom