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Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1991 Oct;44(10):862–865. doi: 10.1136/jcp.44.10.862

Audit of necropsies in a British district general hospital.

M D Harris 1, J W Blundell 1
PMCID: PMC496676  PMID: 1960222

Abstract

A comprehensive study was made of the value of necropsies carried out over a six month period in Peterborough Health Authority, using a modification of the format proposed by Schned et al in Vermont, United States of America. Cause of death, clinical correlation, clinical factors contributing to death and clinical evaluation of the necropsy were recorded. The principal diseases were cardiac (33%), and neoplastic (29%). The pathologist disagreed with the clinical cause of death in 13% of cases and major unsuspected diagnoses were found in 30%. Seventy nine per cent of necropsies provided additional information, including feedback on clinical investigations. Clinicians' questions were answered fully in 87%. Necropsies were rated as "very valuable" in 44% of cases, "valuable" in 54%, and "of no value" in only 2%. In 14% of cases the clinical consultant stated that the results of the necropsy would affect future clinical practice. These findings underline the essential place of necropsies in both audit and postgraduate education. The format described could conveniently be used by other pathology departments as part of an audit program.

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Selected References

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

  1. Anderson R. E., Hill R. B., Gorstein F. A model for the autopsy-based quality assessment of medical diagnostics. Hum Pathol. 1990 Feb;21(2):174–181. doi: 10.1016/0046-8177(90)90126-p. [DOI] [PubMed] [Google Scholar]
  2. 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]
  3. Cameron H. M., McGoogan E. A prospective study of 1152 hospital autopsies: II. Analysis of inaccuracies in clinical diagnoses and their significance. J Pathol. 1981 Apr;133(4):285–300. doi: 10.1002/path.1711330403. [DOI] [PubMed] [Google Scholar]
  4. 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]
  5. Chana J., Rhys-Maitland R., Hon P., Scott P., Thomas C., Hopkins A. Who asks permission for an autopsy? J R Coll Physicians Lond. 1990 Jul;24(3):185–188. [PMC free article] [PubMed] [Google Scholar]
  6. Fowler E. F., Nicol A. G., Reid I. N. Evaluation of a teaching hospital necropsy service. J Clin Pathol. 1977 Jun;30(6):575–578. doi: 10.1136/jcp.30.6.575. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Goldman L., Sayson R., Robbins S., Cohn L. H., Bettmann M., Weisberg M. The value of the autopsy in three medical eras. N Engl J Med. 1983 Apr 28;308(17):1000–1005. doi: 10.1056/NEJM198304283081704. [DOI] [PubMed] [Google Scholar]
  8. Harrison M., Hourihane D. O. Quality assurance programme for necropsies. J Clin Pathol. 1989 Nov;42(11):1190–1193. doi: 10.1136/jcp.42.11.1190. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Hill R. B., Anderson R. E. Is a valid quality assurance program possible without the autopsy? Hum Pathol. 1988 Oct;19(10):1125–1126. doi: 10.1016/s0046-8177(88)80142-4. [DOI] [PubMed] [Google Scholar]
  10. Ibsen H. The effect of potassium chloride and spironolactone on the thiazide-induced potassium depletion in patients with essential hypertension. Acta Med Scand. 1974 Jul-Aug;196(1-2):21–26. doi: 10.1111/j.0954-6820.1974.tb00961.x. [DOI] [PubMed] [Google Scholar]
  11. Karwinski B., Hartveit F. Death certification: increased clinical confidence in diagnosis and lack of interest in confirmation by necropsy is not justified. J Clin Pathol. 1989 Jan;42(1):13–17. doi: 10.1136/jcp.42.1.13. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Kircher T., Nelson J., Burdo H. The autopsy as a measure of accuracy of the death certificate. N Engl J Med. 1985 Nov 14;313(20):1263–1269. doi: 10.1056/NEJM198511143132005. [DOI] [PubMed] [Google Scholar]
  13. 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]
  14. Schned A. R., Mogielnicki R. P., Stauffer M. E. A comprehensive quality assessment program on the autopsy service. Am J Clin Pathol. 1986 Aug;86(2):133–138. doi: 10.1093/ajcp/86.2.133. [DOI] [PubMed] [Google Scholar]
  15. Thurlbeck W. M. Accuracy of clinical diagnosis in a Canadian teaching hospital. Can Med Assoc J. 1981 Sep 1;125(5):443–447. [PMC free article] [PubMed] [Google Scholar]

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