Agreement between ante-mortem diagnoses, death certificates and post-mortem causes of death in critically ill patients

Abstract

Objectives: The aims of the study were: i) to determine the agreement between the ante-mortem clinical diagnoses, death certificates and post-mortem causes of death; ii) to determine the incidence of unexpected findings; and iii) to compare the post-mortem rates on the intensive care unit with national recommendations. Design: Retrospective observational study. Setting: Adult general intensive care unit. Subjects: Critically ill patients. Interventions: Post-mortem examination. Measurements and main results: The post-mortem rate was calculated by checking the post-mortem register. The disease or condition leading directly to death (Ia on the death certificate and post-mortem report) in patients who died on the intensive care unit in our hospital was compared with the ante-mortem clinical diagnosis. The level of agreement between the ante-mortem cause of death, death certificate and post-mortem report was assessed. Unexpected post-mortem findings were noted and their probable impact on the patient's outcom...