Study of Clinical-Pathological Discrepancies in Autopsies

Abstract

Background: Autopsy is a traditional method in pathology for the study of diseases or injuries, being key to elucidate the cause of death. However, the number of autopsies has been decreasing progressively. Design and Context: Retrospective cross-sectional study to analyze the presence of discrepancy between clinical and pathological diagnoses as to the cause of death according to the Goldman criteria, verify the epidemiological profile of the main causes of death, and tabulate the number of procedures conducted annually. Method: Analyzing clinical records and autopsy reports from the Department of Pathology and Legal Medicine of the Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) from 1963 to 2012 and performing statistical analysis on the data collected. Results: The predominant age group was of dead fetuses (30.6% of all cases). The main cause of death was infection (68.4% of diagnoses). After a peak in the early 1980s, there was a progressive drop in the rates of postmortem examination. In the 1990s, the average number of autopsies fell by 58% in relation to the previous decade, and the last decade of the Century registered a decrease of 80% as compared to the average of the 1980s. According to the Goldman criteria, there was discrepancy between ante- and postmortem diagnoses as to the cause of death in 26.2% of the cases. Conclusion: The rates of discrepancy between clinical diagnoses and autopsy findings regarding the cause of death remain high, even though medicine has become more and more advanced in technology.