Study of Gastrointestinal Causes of Death: A 5-Year Autopsy Based Study

Abstract

Introduction: Gastrointestinal disorders (GI) including hepatobiliary-pancreatic (HBP) diseases are a cause for significant morbidity and mortality. Mortality due to nonmalignant disorders are often diagnosed but are less studied. Limited autopsy-based studies have been conducted on gastrointestinal causes of death despite gastrointestinal and hepato-biliary-pancreatic diseases being one of the important causes for morbidity and mortality. Autopsy is still considered a valuable tool in reliably determining the underlying pathology and cause of death. This study of gastrointestinal causes of death was conducted to evaluate and understand its impact. Methods: This is a 5-year retrospective autopsy-based study for the period August 2016 to July 2021. Data was collected from autopsy request forms, patients’ hospital records and autopsy reports, which included age, gender, ethnicity, salient clinical features, key autopsy findings and the cause of death. Results: During the 5-year period, a total of 3435 autopsies were performed, out of which 294 cases were found to have gastrointestinal-hepato-biliarypancreatic (GIHBP) disorders as the cause of death, contributing to 8.6%. This accounts for the third leading cause of death. The main causes of death were gastrointestinal bleeding (GIB) (26%), perforation of a viscus organ and peritonitis (23%), hepato-biliary-pancreatic disease (17%), ischemic bowel changes (13.6%), neoplastic disease (11.6%) and others. Majority of patients were males and of African ethnicity. Patients aged above 40 years accounted for 83% of the deaths. Abdominal pain was the most common presenting symptom. Three leading autopsy findings include gastrointestinal bleeding, ascites, perforation and peritonitis. Conclusion: GIHBP disorders are the third leading cause of death. GI bleeding, non-traumatic perforation and peritonitis are identified as significant mechanisms of death. Autopsy still plays an important role in reliably determining the cause of death. Prompt diagnosis and appropriate management may decrease mortality. This study augments the limited body of literature and provides insight into gastrointestinal causes of death.