Abstract
BACKGROUND : Autopsy rates have been declining world-wide; the ever-increasing availability of advanced diagnostic tests, complex legal procedure, and fear of medico-legal lawsuits appear to be some of the contributing factors. Clinical judgment errors however have shown no decline and continue to remain a source of concern. Mortality and morbidity data statistics become relevant in framing health policies only when validated by corresponding autopsy studies. The present study was conducted to ascertain the utility of autopsy as a modern diagnostic tool. METHODS : A prospective study of hundred consecutive cases of medico-legal autopsies received in the Pathology Department was carried out for their demographic characteristics with a comparative analysis between the initial cause of death and final autopsy diagnosis. The utility of autopsy in discovering hitherto unknown incidental pathologies was also evaluated. RESULTS: In 17.6 % of cases, the final cause of death was revealed only after autopsy. It proved especially beneficial in discovering latent cardiac illnesses, occult visceral bleed sites, and undiagnosed respiratory and infectious pathologies. Hitherto unknown incidental findings which were not directly responsible for death but nevertheless enhance our understanding of different pathologic processes were found in 16.5 % of cases. CONCLUSION: The study confirmed the utility of autopsy as an important diagnostic tool in revealing the true cause of death and contributing to our understanding of evolution of different disease processes. Simplifying the legal procedure will encourage more autopsies, stirring the clinician’s interest and involvement in autopsy studies.
Highlights
Autopsy studies are the most authentic means to confirm cause of mortality and evaluate ante mortem diagnosis made on the basis of clinical opinion and laboratory investigations
A comparison between the initial basic cause of death and the final autopsy diagnosis arrived revealed a consensus between ante mortem and postmortem opinion in 54.9 % with autopsy exclusively clinching the final cause of death in 17.6 %
Many interesting findings which though not directly related to the cause of death but have a significance of their own in studying the natural progression and morbidity patterns of various diseases were detected on tissue histopathology, some of them presented in a tabulated form in Table-2
Summary
Autopsy studies are the most authentic means to confirm cause of mortality and evaluate ante mortem diagnosis made on the basis of clinical opinion and laboratory investigations. Availability of an ever increasing number of advanced, modern diagnostic tests with clinicians increasingly laying their faith in them to make a diagnosis, the complexity of the legal procedure involved in ordering an autopsy, compounded by the fear of autopsy revealing hitherto unknown findings/complications triggering law-suits are some of the reasons alienating clinicians from autopsy discussions This declining trend in autopsy rates has been observed world-wide.[2] studies comparing accuracy of the clinical diagnosis over different eras have shown no decline in the clinical judgment errors.[3, 4, 5, 6, 7, 8]. The present study was conducted to ascertain the utility of autopsy as a modern diagnostic tool
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