[Quality control by autopsy. How often do the postmortem examination findings correct the clinical diagnosis?]

Abstract

To ascertain whether autopsies still provide important information in the face of modern diagnostic procedures, the findings in 780 autopsies (543 men and 237 women: mean age 58 [1-94] years), performed between 1977 and 1990, were compared with the clinical diagnoses. Autopsy confirmed the clinical diagnosis in 74.9% of cases, a clinically not diagnosed basic disease was demonstrated in 13.6%, and a not recognized final complication in 11.5%. In 9.7% of autopsies previously unrecognized but clinically important additional diseases were found. There was no decrease in the proportion of unrecognized basic diseases in the course of the observation period. It was unrelated to the duration of hospital stay, but increased with increasing age of the patients. These observations indicate that even nowadays, in the age of highly technical medicine, autopsies point to any limitations of diagnosis and are thus of importance for clinical quality control.