Should we confirm our clinical diagnostic certainty by autopsies?

Podbregar, Matej; Voga, Gorazd; Krivec, Bojan; Skale, Rafael; Parežnik, Roman; Gabršček, Lucija

doi:10.1007/s00134-001-1129-x

Cited by 79 publications

(48 citation statements)

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“…Parents of infants with uncertain antemortem diagnoses are potentially more likely to grant permission for autopsy, which could cause a selection bias. Therefore, the number of additional findings in the present study might be higher than the number of findings in all deceased NICU patients [18, 19]. However, minor Goldman findings were present even after a more prolonged NICU stay, suggesting that these additional findings could have been found in deceased patients without permission for autopsy as well.…”

Section: Discussioncontrasting

confidence: 45%

The Value of Autopsy in Neonates in the 21st Century

et al. 2018

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Background: Autopsy rates in neonatal intensive care unit (NICU) patients who died are declining worldwide. Postmortem magnetic resonance imaging (MRI) is suggested as adjunct to or substitute for autopsy. Objective: The aim of this paper was to determine the additional diagnostic value of autopsy in NICU patients and whether autopsy findings were potentially detectable using postmortem MRI. Methods: From 2008 to 2015, 298 infants died during admission to our NICU. Permission for unrestricted, nonforensic autopsy was obtained in 100 (33.6%) of these 298 infants. Retrospectively, autopsy reports and medical records of NICU patients were compared. Additional autopsy findings were graded according to the Goldman system, grading the clinical relevance of additional findings. In addition, the potential detectability of these additional findings on postmortem MRI was assessed. Results: Additional findings obtained by autopsy were found in 48% of the cases, divided into major (Goldman I/II, 24%) and minor (Goldman III/IV, 24%) additional findings. Major additional findings were significantly more often found in patients with a lower gestational age, and minor additional findings in patients with a higher postnatal age at death. Of all patients with additional findings determined by autopsy, 56.3% would most likely not have been detected using postmortem MRI. Conclusions: Our results emphasize the still very important role of autopsy in the NICU setting and show that conventional autopsy could probably not be completely substituted by postmortem MRI.

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Section: Discussioncontrasting

confidence: 45%

The Value of Autopsy in Neonates in the 21st Century

et al. 2018

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“…Podbreg ar et al [11] 2001 126 52 10.5 In our study class I discrepancies were found in 31 cases of total 63 discrepant cases (49.21%), which is concordant with a MICU study of Tai et al [8] who reported 44% (8 of 18) of class I errors.…”

Section: Discussionsupporting

confidence: 90%

The Role of Autopsy in Medical Intensive Care Unit: Comparison of Clinical and Postmortem Diagnoses

Dahake¹,

Khedekar²,

Faizal³

et al. 2016

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“…This observation has also been made by other investigators [2,3,6] and emphasises the difficulty of diagnosing unexpected or new pathogens in patients with already manifest infections. For example, the number of Legionella infections in Finland is very low, 6-12 cases annually, as is the incidence of tuber- [7].…”

Section: Discussionmentioning

confidence: 74%