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. 1993 Mar;48(3):284–286. doi: 10.1136/thx.48.3.284

Deaths and necropsies in a thoracic unit.

D A Boldy 1, C Jones 1, H Matthews 1, C Edwards 1
PMCID: PMC464372  PMID: 8497830

Abstract

BACKGROUND: There is concern about the decrease in the number of requests for necropsies, so a study was undertaken to assess current clinical practice. METHOD: A prospective study was made of all deaths occurring under the care of five chest physicians and three thoracic surgeons at East Birmingham Hospital from 1 April to 30 June 1989. RESULTS: A necropsy was sought in 34 of 58 deaths (59%) and was performed in 22 instances (38%). Major unexpected findings which would have affected clinical management were noted in three patients (14%). The mean delay in reporting results of histological examinations was 146 days (range 41-260 days). As the result of an increase in pathology technical staff levels and alteration in the practice of processing histological data, there was a substantial improvement during the corresponding period in 1990 (mean reduction 58 days, 95% confidence limits 39-77 days). Apart from patients with histologically proved carcinoma, there was no consistent pattern for requests for necropsies. CONCLUSIONS: Necropsies continue to reveal diagnoses which were not suspected while the patient was alive. Although the number of requests made by clinical staff for necropsies is reasonable, the reasons for the requests are not consistent. Guidelines are suggested to improve the number of successful requests and to maximise the information obtained from them.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Battle R. M., Pathak D., Humble C. G., Key C. R., Vanatta P. R., Hill R. B., Anderson R. E. Factors influencing discrepancies between premortem and postmortem diagnoses. JAMA. 1987 Jul 17;258(3):339–344. [PubMed] [Google Scholar]
  2. Britton M. Diagnostic errors discovered at autopsy. Acta Med Scand. 1974 Sep;196(3):203–210. doi: 10.1111/j.0954-6820.1974.tb00996.x. [DOI] [PubMed] [Google Scholar]
  3. Cameron H. M. Future of the hospital autopsy. Br J Hosp Med. 1988 Nov;40(5):335–335. [PubMed] [Google Scholar]
  4. Cameron H. M., McGoogan E. A prospective study of 1152 hospital autopsies: I. Inaccuracies in death certification. J Pathol. 1981 Apr;133(4):273–283. doi: 10.1002/path.1711330402. [DOI] [PubMed] [Google Scholar]
  5. Cameron H. M., McGoogan E., Watson H. Necropsy: a yardstick for clinical diagnoses. Br Med J. 1980 Oct 11;281(6246):985–988. doi: 10.1136/bmj.281.6246.985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Gau G. The ultimate audit. Br Med J. 1977 Jun 18;1(6076):1580–1581. doi: 10.1136/bmj.1.6076.1580. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Kattamis C., Tzotzos S., Kanavakis E., Synodinos J., Metaxotou-Mavrommati A. Correlation of clinical phenotype to genotype in haemoglobin H disease. Lancet. 1988 Feb 27;1(8583):442–444. doi: 10.1016/s0140-6736(88)91234-2. [DOI] [PubMed] [Google Scholar]
  8. Landefeld C. S., Chren M. M., Myers A., Geller R., Robbins S., Goldman L. Diagnostic yield of the autopsy in a university hospital and a community hospital. N Engl J Med. 1988 May 12;318(19):1249–1254. doi: 10.1056/NEJM198805123181906. [DOI] [PubMed] [Google Scholar]
  9. Puxty J. A., Horan M. A., Fox R. A. Necropsies in the elderly. Lancet. 1983 Jun 4;1(8336):1262–1264. doi: 10.1016/s0140-6736(83)92708-3. [DOI] [PubMed] [Google Scholar]
  10. Reid W. A. Cost effectiveness of routine postmortem histology. J Clin Pathol. 1987 Apr;40(4):459–461. doi: 10.1136/jcp.40.4.459. [DOI] [PMC free article] [PubMed] [Google Scholar]

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