Value of autopsy in the modern age: Discrepancy between clinical and autopsy diagnoses

Abstract

Background: Autopsy is a medical procedure that consists of the examination of the corpse to determine the cause of death and obtain information on pathological conditions or injuries. In recent years, there has been a reduction in hospital autopsies and an increase in forensic autopsies.

Aim: To evaluate the utility of autopsy in the modern age and the discrepancy between clinical and autopsy diagnoses.

Methods: A retrospective observational study was conducted on the reports of all 645 hospital autopsies performed at Polyclinic of Bari from 2006 to 2021.

Results: Group A, 2006-2009, 174 cases were studied: 58% male, 58% adults, 55% neonatology; pulmonary disease was the cause of death in 23% of cases; and there was a discrepancy between clinical and autopsy diagnosis in 55% of cases. Group B, 2010-2013, 119 cases: 52% male, 46% infants, 48% neonatology; pulmonary disease was the cause of death in 25% of cases; and there was a discrepancy between clinical and autopsy diagnosis in 56% of cases. Group C, 2014-2017, 168 cases: sex equality, 37% infants, 25% gynecology; pulmonary disease was the cause of death in 24% of cases; and there was a discrepancy between clinical and autopsy diagnosis in 58% of cases. Group D, 2018-2021, 184 cases: 56% male, 38% adult, 32% gynecology; pulmonary disease was the cause of death in 27% of cases; and there was a discrepancy between clinical and autopsy diagnosis in 58% of cases.

Conclusion: The study of hospital autopsies reveals a 56.75% discrepancy between clinical diagnosis and autopsy, highlighting the importance of autopsies, especially for fetal and neonatal diseases, which represent 59% of cases.

Keywords: Autopsy diagnosis; Clinical diagnosis; Hospital autopsy; Modern age; Public health.

Figure 1

Discrepancy between clinical and autopsy diagnosis. A: Group A discrepancy of 55%; B: Group B discrepancy of 56%; C: Group C discrepancy of 58%; D: Group D discrepancy of 58%.