An Analysis of 60 Years of Autopsy Data from Zhejiang University in Hangzhou, China

Abstract

ContextThe autopsy rate gradually decreased during 1950–1999, and increased during the most recent decade (2000–2009). The diagnostic inaccuracy rate was continuously high during the 60 years.ObjectiveTo investigate disagreement between the pathological and clinical diagnosis during 60 years (1950–2009).Data SourcesA 60-year retrospective study was carried out on the 4140 autopsy cases performed in Zhejiang University School of Medicine.ResultsThe highest number of cases was 1037 during 1960–1969, while the lowest was 102 during 1990–1999. During the 1999–2009 period, 978 cases were completed, which ranked second within the 60 years. The total clinical misdiagnosis rate was 46.38%, while the highest was 73.82% in 2000–2009. During the 60 years, the diseases associated with highest diagnostic inaccuracy rates were circulatory diseases (76.97%), cancer (60.99%), and brain diseases (54.48%). The invasive fungal infection rate was 1.84% of the 4140 cases, and the diagnostic inaccuracy rate for this condition reached as high as 86.10%. In the autopsied disease spectrum over the 60 years, the most common diseases were respiratory (1349, 32.58%), circulatory (495, 11.96%), and brain diseases (424, 10.24%).ConclusionAlthough the number of autopsies decreased from 1950 to 1999, it increased from 2000 to 2009, while the discordance rate between clinical and autopsy diagnosis remained high throughout.

Evaluation of the discrepancy between clinical diagnostic hypotheses and anatomopathological diagnoses resulting from autopsies

“…This is in agreement with results published by Fares et al 17, Aalten et al 18 and Kotovicz et al 19. However, some previously published articles stated that the discrepancy is related to the shorter duration of care 15,20,21 and sex and age differences 14,15.…”

Fetal, neonatal, and infant death in central China (Hubei)

“…The National Health and Family Planning Commission of PR China requires that hospitals belonging to the III and II grades must attain autopsy rates of at least 15% and 10%, respectively. However, these percentages are not achieved in many hospitals, [5] mainly because of parental refusal, lack of awareness of the importance of autopsy, neglect of medical workers, helpless pathologists, and so on. From 1998 to 2008, the autopsy rates in China's different representative hospitals were 0.04% to 2.04%, and some hospitals did not perform a single autopsy for years.…”

“…From 1998 to 2008, the autopsy rates in China's different representative hospitals were 0.04% to 2.04%, and some hospitals did not perform a single autopsy for years. [5,12] In TMFC, the mean annual autopsy number was only 10.8, though there has been a rising tendency since 2010. In this study, the purposes of these autopsies were mainly for the following reasons: investigation of unexpected fetal or infant deaths for the purpose of medical litigation claims; identification of the cause of unexpected fetal death as guidance for subsequent pregnancies; and criminal investigations.…”

“…[3,4] Autopsy improves definitive diagnosis, informs genetic counseling, and assists in medical malpractice evaluation and resolving medical disputes. [5–9] It is additionally useful in criminal investigation.…”

Agromyces kandeliae sp. nov., isolated from rhizosphere soil of Kandelia candel in a mangrove

“…Hydrolysis of Tweens (20, 40, 60 and 80) and production of urease were determined as described by Zhu et al . [31]. MA containing 0.5% l -tyrosine was used to test the degradation of l -tyrosine.…”