[Clinical autopsy: a useful tool in the emergency department of teaching hospitals]

We aimed to know the usefulness of clinical autopsy at the medical room of an emergency department in a teaching hospital.

Retrospective study of clinical autopsies performed in the emergency department of a teaching hospital between 1995 and 2000. We explored the correlation between clinical emergency and autopsy diagnosis.

The number of deaths was 1,484 (0.9%) among 165,662 patients attended in the emergency medical room in the study period. Of 281 autopsies (18.9%), 227 (15.3%) were judicial. Only 54 clinical autopsies (3.6%) were included. Dyspnea and chest pain, the two more frequent guide symptoms, were in concordance with the two more prevalent initial clinical diagnoses: respiratory and cardiovascular diseases. 38.9% (21 cases) of autopsies agreed with the clinical diagnosis and 14.8% (8 cases) did not agree with it. 25.9% (14 cases) of autopsies were diagnostic since the clinical diagnosis, both initial and final, was unknown. Moreover, 14.8% (8 cases) autopsies were explanatory. Furthermore, 5.6% (3 cases) of autopsies were undetermined. With regard to the main cause of death, there were 9 (16.7%) cases of previously unknown neoplasms.

The results of the present study confirm the need and usefulness of autopsy in patients dying in the medical room of emergency departments, as well as the crucial role of the clinico-pathological exercise in the definitive diagnosis of the postmortem examination.