[20-year cooperation between the I Department of Internal medicine of the District Hospital and the Department of Pathological Anatomy, Medical Academy, in Białystok (analysis of diagnostic consistency)].

Abstract

Statistical analysis of 1421 deaths (98% of all who had died at the Ward) of patients during 1965-1984 was performed. The material was divided into 3 groups according to the age: up to 59 years, from 60 to 69 and over 70 years. Among those who had died men prevailed (55.1%), but both among women and men the age was over 70 years. In the 2nd decade of the analysed period the authors found gradual increase of death percentage among elderly people, that can be ascribed to "geriatrization" of the Ward and higher accessibility to the hospital for this group of patients. Statistical analysis which included a 10-year period (1975-1984) dealt with the causes of deaths according to the clinical and pathological recognition. There dominated deaths of cardiovascular diseases (59.4%), twice increased the percent of deaths due to neoplasia and diabetes complications. On the other hand, the proportion of decreased of heart infarction fell (from 33% to 16.9%) as did of cardiac defects (from 9.5% to 5.9%). This decrease was the effect of hospital structure changes, i.e.a creation of the Ward of Cardiology and Intensive Cardiological Care in 1981. During 1981-1984 the proportion of deaths of complications of arterial hypertension, mainly in the persons at very old age, increased threefold. In this group of age there dominated deaths of cardiac infarction and circulatory insufficiency. The authors made an analysis of the conformability of clinical diagnosis and the results of autopsy. Out of 1421 deaths in 1149 cases (80.8%) the results of autopsy fully agreed with clinical diagnosis. As partially conformable the clinical diagnosis was in 15.5%, and divergent in 3.7% of cases. The latter, according to the authors, resulted from an incomplete or unproper interpretation of diseases symptoms influenced by several objective factors. As could be expected, the highest proportion of divergent diagnosis was found in the group of the eldest patients afflicted with cardiovascular and malignant diseases.