Correlation between clinincal and autopsy diagnoses in 150 cases seen in university of Port Harcourt teaching hospital, Port Harcourt

Abstract

Background : Autopsy is a veritable tool for auditing the accuracy of clinincal diagnosis. This study determined the accuracy of clinical diagnosis of diseases using autopsy result. The present report was informed by the unusual presentation of this case and the intent of increasing the index of diagnostic suspicion. A brief appraisal is provided of the clinical parameters, management strategies and challenges. Method : A twelve year consecutive clinico-autopsy study. (1st Jan 1995 – 31st Dec, 2006) at University of Port Harcourt Teaching Hospital (UPTH), was carried out. A total of 150 patients who were previously diagnosed of various diseases and treated for variable period of time, and later died were thoroughly autopsied on request to ascertain the cause of death. Of the 2848 autopsies performed during the study period, 150 were hospital autopsies representing 5.3% of the total autopsies. The 2698 (94.7%) medicolegal autopsies were excluded from the study. Result : The autopsies were performed on patient of both sexes of different ages. Ninety (60%) autopsies were males and 60 (40%) female, giving a male to female ratio of 1.5:1. Out of 150 clinincally diagnosed cases, autopsy accurately confirmed 127 (84.6%) (84.6% concordance rate) and varied in 23 (15.4% discordant rate). Conclusion : Autopsy pathology is beneficial to the clinician, the surviving relatives and constitutes a vital tool for medical education. It should be incorporated in the patient care and management delivery system in the country.