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Published on: August 9, 2024

Comparison between clinical and autopsy diagnoses in a cardiology hospital

Rafael Saad1, Alice Tatsuko Yamada, Fernando Henrique Ferraz Pereira da Rosa

  • 1Heart Institute (InCor), University of São Paulo Medical School, Brazil.

Heart (British Cardiac Society)
|March 31, 2007
PubMed

Insights

Older age increases diagnostic errors between clinical and autopsy findings, while intensive care reduces them. Pulmonary embolism showed the highest discrepancy rate in this cardiology hospital study.

Area of Science:

  • Medical diagnostics
  • Clinical pathology
  • Autopsy studies

Background:

  • Diagnostic accuracy is crucial in cardiology.
  • Few studies compare clinical and autopsy diagnoses in specialized cardiac hospitals.

Purpose of the Study:

  • To evaluate diagnostic accuracy by comparing clinical and autopsy diagnoses.
  • To identify factors influencing diagnostic discrepancies in a cardiology setting.

Main Methods:

  • Analysis of 406 consecutive autopsy cases over two years.
  • Categorization of diagnostic discrepancies (Classes I-V) based on therapeutic/prognostic impact.
  • Statistical analysis using Chi-squared test and logistic regression.

Main Results:

  • Increasing age significantly raised the risk of major diagnostic discrepancies (Classes I-II).
  • Intensive care unit admission decreased the risk of major discrepancies.
  • Pulmonary embolism had the highest diagnostic discrepancy rate (34.1% in Classes I-II).
  • Concordance rates varied: 71.1% for myocardial infarction, 75% for aorta dissection, 73.1% for infective endocarditis, and 35.2% for pulmonary embolism.

Conclusions:

  • Age and hospital ward significantly influence diagnostic concordance/discrepancy.
  • Lower discrepancy rates for myocardial infarction and infective endocarditis may be due to the specialist hospital environment.
Abstract

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