Valor del estudio anatomopatológico en cuidados intensivos pediátricos

Abstract

Autopsy is being used less and less frequently in paedriatrics inspite of giving valuable and at times unsuspected clinical information. This could partly be explained in the greater availibility of non-invasive diagnostic techniques and fundamentally in the difficulty of obtaining parental consent to perform them. However, to clarify the cause of death is of great importance not only for the medical team but also for the family. We performed a retrospective analysis of mortality during a 4 year period, classifying the pathology in accordance with the criteria of Goldman with respect to diagnostic groups and autopsy findings. 87 patients died, autopsy being performed in 61, 47 in the hospital Dr. Sotero del Rio and 14 in the Medico-Legal Institute. Parental consent was not obtained in 26 patients (36%). There was no correlation between autopsy findings and the primary diagnostic variables, age, time spent in ITU, and PRISM (Paedriatric Risk of Mortality scale). In 26% of cases there were some type of diagnostic error, 11% corresponding to Goldman type I (diagnosis revealed at autopsy and which could have modified the treatment and outcome, and 15% type II. Thus autopsy should still be considered as an integral part of medical evaluation of the paedriatric patient.