With new, more accurate imaging techniques and clinical investigations currently available, it may appear that post mortem examination (PME) provides little information that is not already available during life regarding disease processes. This is especially the case where the cause of death appears self-evident, as in patients suffering from malignancy. To determine whether PME in such patients does provide new information regarding disease, a review was conducted of PMEs conducted at the ACH during the ten year period 1982-1991. During this period 67 patients under the care of the Oncology Department died within the hospital, and 31 (47.8%l underwent PME. During the same period 602 non-oncology patients died in the ACH and 454 (75.4%) underwent PME. There were significant new pathological findings in 10 (32%) of the 31 PMEs undertaken on oncology patients. Had the findings been known during life in 5 cases, treatment would probably have been altered. This group includes: 3 patients with leukaemia dying of sepsis in whom the infective agent was only identified at PME; 1 patient with Ewing's sarcoma dying suddenly at home from treatment-related renal failure and another patient with Ewing's sarcoma and treatment-related cardiomyopathy dying from cardiac failure, with numerous clinically-occult pulmonary emboli. In 5 patients, the new pathologic findings would not have influenced treatment had they been known during life. In one case PME did show that complications that were suspected clinically to be related to treatment, were instead due to leukaemic infiltration and in one patient with metastatic osteosarcoma and a presumed bacterial endocarditis, PME found a sinus tract leading from the oesophagus into a large intra-atrial tumour mass. PME In this paediatric oncology patient population, although less frequent than in non- oncology patients, had a high yield of significant findings that provided information both on the disease process and on treatment responses and complications. The benefits of PME are thus clear, and to highlight these factors and to help parents in making their decision regarding consent for autopsy, a pamphlet explaining the process of autopsy and detailing its advantages has been recently developed at the ACH for distribution to clinical services. With new, more accurate imaging techniques and clinical investigations currently available, it may appear that post mortem examination (PME) provides little information that is not already available during life regarding disease processes. This is especially the case where the cause of death appears self-evident, as in patients suffering from malignancy. To determine whether PME in such patients does provide new information regarding disease, a review was conducted of PMEs conducted at the ACH during the ten year period 1982-1991. During this period 67 patients under the care of the Oncology Department died within the hospital, and 31 (47.8%l underwent PME. During the same period 602 non-oncology patients died in the ACH and 454 (75.4%) underwent PME. There were significant new pathological findings in 10 (32%) of the 31 PMEs undertaken on oncology patients. Had the findings been known during life in 5 cases, treatment would probably have been altered. This group includes: 3 patients with leukaemia dying of sepsis in whom the infective agent was only identified at PME; 1 patient with Ewing's sarcoma dying suddenly at home from treatment-related renal failure and another patient with Ewing's sarcoma and treatment-related cardiomyopathy dying from cardiac failure, with numerous clinically-occult pulmonary emboli. In 5 patients, the new pathologic findings would not have influenced treatment had they been known during life. In one case PME did show that complications that were suspected clinically to be related to treatment, were instead due to leukaemic infiltration and in one patient with metastatic osteosarcoma and a presumed bacterial endocarditis, PME found a sinus tract leading from the oesophagus into a large intra-atrial tumour mass. PME In this paediatric oncology patient population, although less frequent than in non- oncology patients, had a high yield of significant findings that provided information both on the disease process and on treatment responses and complications. The benefits of PME are thus clear, and to highlight these factors and to help parents in making their decision regarding consent for autopsy, a pamphlet explaining the process of autopsy and detailing its advantages has been recently developed at the ACH for distribution to clinical services.
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