Discrepancies between clinical diagnosis and hospital autopsy: A comparative retrospective analysis of 1,112 cases

• Published in: PloS one 2021-08, Vol.16 (8), p.e0255490-e0255490
• Main Authors: Kurz, Stephan D, Sido, Viyan, Herbst, Hermann, Ulm, Bernhard, Salkic, Erma, Ruschinski, Thomas M, Buschmann, Claas T, Tsokos, Michael
• Format: Article
• Language: English
• Subjects: Age; Anesthesiology; Autopsies; Autopsy; Biology and Life Sciences; Body mass; Body mass index; Body size; Cardiovascular diseases; Cardiovascular system; Comparative analysis; Diagnosis; Disease; Heart attacks; Heart failure; Heart surgery; Hospitals; Legal medicine; Medical diagnosis; Medicine and Health Sciences; Methods; Patients; Regression analysis; Sepsis; Variables
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0255490

Aims The aim of this study was to compare discrepancies between diagnosed and autopsied causes of death in 1,112 hospital autopsies and to determine the factors causing this discrepancies. Methods 1,112 hospital autopsies between 2010 and 2013 were retrospectively studied. Ante-mortem diagnoses were compared to causes of death as determined by autopsy. Clinical diagnoses were extracted from the autopsy request form, and post-mortem diagnoses were assessed from respective autopsy reports. Variables, such as sex, age, Body Mass Index, category of disease, duration of hospital stay and new-borns were studied in comparison to discrepancy. P-values were derived from the Mann-Whitney U test for the constant features and chi-2 test, p-values < 0,05 were considered significant. Results 73.9% (n = 822) patients showed no discrepancy between autopsy and clinical diagnosis. The duration of hospitalisation (6 vs. 9 days) and diseases of the cardiovascular system (61.7%) had a significant impact on discrepancies. Conclusion Age, cardiovascular diseases and duration of hospital stay significantly affect discrepancies in ante- and post-mortem diagnoses.