Post mortem examination in the intensive care unit: Still useful?

Post mortem examination rates have decreased worldwide and their usefulness has been challenged. The aim of this study was to compare ante- versus post mortem findings in a multidisciplinary ICU. Retrospective study. Thirty-one-bed, medico-surgical ICU. All patients who died on the ICU and underwent...

Full description

Saved in:
Bibliographic Details
Published in:Intensive care medicine 2004-11, Vol.30 (11), p.2080-2085
Main Authors: DIMOPOULOS, George, PIAGNERELLI, Michael, BERRE, Jacques, SALMON, Isabelle, VINCENT, Jean-Louis
Format: Article
Language:English
Subjects:
Aged
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Autopsies
Autopsy
Belgium - epidemiology
Biological and medical sciences
Cause of Death
Clinical death. Palliative care. Organ gift and preservation
Decades
Diagnostic Errors - statistics & numerical data
Female
Heart attacks
Hospitals
Humans
Intensive care
Intensive care medicine
Intensive Care Units
Investigative techniques, diagnostic techniques (general aspects)
Length of Stay
Male
Medical sciences
Nosocomial infections
Patient admissions
Radiodiagnosis. Nmr imagery. Nmr spectrometry
Respiratory system
Retrospective Studies
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Post mortem examination rates have decreased worldwide and their usefulness has been challenged. The aim of this study was to compare ante- versus post mortem findings in a multidisciplinary ICU. Retrospective study. Thirty-one-bed, medico-surgical ICU. All patients who died on the ICU and underwent an autopsy examination in 1999. Records from autopsies were compared with clinical records. A modified Goldman's criteria was used to categorize the post mortem diagnoses. Unexpected findings were evaluated according to the duration of hospitalization prior to death (fewer than or more than 10 days). Among 2,984 ICU admissions, there were 489 deaths; 222 autopsies were conducted (45.4% autopsy rate). Post mortem examination revealed unexpected findings in 50 patients (22.5%), including malignancy (22 [9.9%]), fungal infections (9 [4%]), pulmonary embolism (7 [3.2%]), nosocomial infections (3 [1.3%]), Hashimoto's disease (3 [1.3%]), mesenteric infarction (2 [0.9%]), Barrett's esophagus (2 [0.9%]), endocarditis (1 [0.5%]) and myocardial infarction (1 [0.5%]). These unexpected findings were considered as major (Class I/II) in 19 (8.5%), and minor (Class III) in 31 (14%) patients. In patients with a short ICU length of stay (10 days), minor unexpected findings were more common. After a short ICU stay (10 days), autopsy was more likely to reveal coexisting diseases unrelated to death.
ISSN:0342-4642
1432-1238
DOI:10.1007/s00134-004-2448-5