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Cause of death and significant disease found at autopsy
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology. Lund Univ, Dept Clin Sci, Div Oncol & Pathol, Solvegatan 25, S-22185 Lund, Sweden;Lund Univ, Dept Pediat, Lasarettsgatan 40, S-22185 Lund, Sweden.
Lund Univ, Dept Clin Sci, Div Oncol & Pathol, Solvegatan 25, S-22185 Lund, Sweden.
Karolinska Inst, Div Transplantat Surg, CLINTEC, Dept Transplantat Surg,Karolinska Univ Hosp, Stockholm, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Clinical Immunology.ORCID iD: 0000-0001-8623-0939
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2019 (English)In: Virchows Archiv, ISSN 0945-6317, E-ISSN 1432-2307, Vol. 475, no 6, p. 781-788Article in journal (Refereed) Published
Abstract [en]

The use of clinical autopsy has been in decline for many years throughout healthcare systems of developed countries despite studies showing substantial discrepancies between autopsy results and pre-mortal clinical diagnoses. We conducted a study to evaluate over time the use and results of clinical autopsies in Sweden. We reviewed the autopsy reports and autopsy referrals of 2410 adult (age > 17) deceased patients referred to two University hospitals in Sweden during two plus two years, a decade apart. There was a decline in the number of autopsies performed over time, however, mainly in one of the two hospitals. The proportion of autopsy referrals from the emergency department increased from 9 to 16%, while the proportion of referrals from regular hospital wards was almost halved. The autopsies revealed a high prevalence of cardiovascular disease, with myocardial infarction and cerebrovascular lesion found in 40% and 19% of all cases, respectively. In a large proportion of cases (> 30%), significant findings of disease were not anticipated before autopsy, as judged from the referral document and additional data obtained in some but not all cases. In accordance with previous research, our study confirms a declining rate of autopsy even at tertiary, academic hospitals and points out factors possibly involved in the decline.

Place, publisher, year, edition, pages
SPRINGER , 2019. Vol. 475, no 6, p. 781-788
Keywords [en]
Autopsy, Cause of death, Diagnostic error, Referral quality
National Category
Other Clinical Medicine
Identifiers
URN: urn:nbn:se:uu:diva-397789DOI: 10.1007/s00428-019-02672-zISI: 000494381500001PubMedID: 31691009OAI: oai:DiVA.org:uu-397789DiVA, id: diva2:1373741
Available from: 2019-11-28 Created: 2019-11-28 Last updated: 2019-11-28Bibliographically approved

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