Abstract
PurposeThe aim of this study was to investigate whether post-mortem computed tomography (PMCT) provides additional information regarding the cause of death and underlying diseases in a general practitioners’ (GP), out-of-hospital population.Methods and materialsBodies donated to our anatomy department between January 2014 and January 2018, who consecutively underwent a total body PMCT and had given permission for retrieval of their medical records during life, were included. PMCT scans were assessed by a radiologist and compared with the cause of death as stated in the medical records. Discrepancies were analyzed with an adjusted Goldman classification.ResultsNinety-three out of the 274 scanned donors during the inclusion period had given consent for the retrieval of their medical records, of which 79 GP’s responded to the request thereof (31 men, 48 women, average age 72.8 years, range 36–99). PMCT identified 49 (62%) cases of cancer, 10 (12.7%) cardiovascular diseases, 8 (10.1%) severe organ failures, 5 (6.3%) cases with signs of pneumonia, 2 (2.5%) other causes, and 7 (8.9%) cases without an (underlying) definitive cause of death. Eleven major discrepancies on the Goldman classification scale, with possible relevance to survival between PMCT and GP records, were identified.ConclusionPMCT can have added value for the detection of additional findings regarding the cause of death in an out-of-hospital, GP’s population, especially to identify or exclude major (previously non-diagnosed) underlying diseases.
Highlights
Cause and manner of death assessment, as assessed by the attending physician or municipal coroner, is a frequent topic of public and scientific debate [1,2,3,4]
Does post-mortem computed tomography (PMCT) provide additional information regarding the cause of death and underlying diseases in a general practitioners’ (GP) population? Secondly, does this PMCT-based diagnosis comply or oppose with cause of death as determined by the GP?
Our results indicate that in the majority of cases PMCT does not provide additional information regarding the cause of death
Summary
Cause and manner (natural or non-natural) of death assessment, as assessed by the attending physician or municipal coroner, is a frequent topic of public and scientific debate [1,2,3,4]. In the Netherlands, registration and documentation on the death certificate are both legally obligatory and important for population statistics and health care quality control [5]. Cause of death determination is often based on medical history and circumstantial evidence rather than a postmortem in-depth medical examination. This sometimes allures to conclusions such as dying of “old age” when the cause of death remains unknown. (hospitalized patients), up to a third of cause of death diagnosed in the Netherlands are incorrect [3]. For an accurate cause of death determination, autopsy is considered the reference standard
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