The impact of antemortem computed tomographic scanning on postmortem examination rate and frequency of missed diagnosis: A retrospective analysis of postmortem examination data

Abstract

PurposeThe present study was conducted to explore the impact of computed tomographic (CT) scanning on the diagnostic discrepancy rate. Materials and methodsThis single-center, retrospective study reviewed postmortem examination results, clinical diagnoses, and radiologic imaging data for patients admitted to the intensive care unit (ICU) in 2008 to 2013. The Goldman criteria were used to classify diagnostic discrepancies. ResultsThe data of 577 patients who died during their ICU stay were retrieved. The postmortem examination rate was 42.9% (n = 248). Significant diagnostic discrepancies (Goldman I and II) were recorded in 24 cases (9.7%).The postmortem examination rate decreased significantly from the first half (n = 143; 51.1%) to the second half (n = 105; 35.4%) of the study period (P < .0001). Among those with postmortem examinations, the use of antemortem body CT scans increased significantly from the first half (n = 59; 41.3%) to the second half (n = 64; 51.0%; P = .002) of the study period. The significant diagnostic discrepancy rate did not change with time (8.4% vs 11.4%, respectively; P = .424). ConclusionThe postmortem examination rate has decreased, whereas antemortem CT scans has increased.