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[Diagnosis in the aged from the pathologic-anatomic viewpoint]
J P Pfuhl1, H H Jansen, U Hübschen
1Zentrum der Frauenheilkunde und Geburtshilfe der Johann-Wolfgang-Goethe-Universität Frankfurt.
Zeitschrift Fur Gerontologie
|November 1, 1989
Summary
Autopsy findings reveal diagnostic discrepancies in older adults, particularly for myocardial infarction and certain carcinomas. High autopsy rates are crucial for accurate geriatric diagnostics and understanding multimorbidity.
Area of Science:
- Pathology
- Geriatric Medicine
- Diagnostic Accuracy
Context:
- Review of 2033 unselected autopsies comparing diagnostic preciseness between two age groups (≤59 and >59 years).
- Focus on eight specific diagnoses to evaluate clinical diagnostic accuracy.
- Addresses the challenge of diagnosing conditions in the elderly, considering multimorbidity.
Purpose:
- To assess the accuracy of clinical diagnostics across different age groups based on autopsy findings.
- To identify specific diagnoses where diagnostic preciseness differs between younger and older populations.
- To highlight the importance of autopsy in geriatric diagnostics.
Summary:
- Myocardial infarction, hepatocirrhosis, bronchial, and gastric carcinomas were less frequently diagnosed in the older age group (>59 years).
- Pulmonary embolism, pulmonary tuberculosis, colon, and breast carcinomas showed similar pre-death diagnostic rates in both age groups.
- Autopsy data revealed significant differences in diagnostic accuracy for certain conditions, emphasizing the impact of age and multimorbidity.
Impact:
- Underscores the need for improved diagnostic strategies in geriatric patients, particularly for conditions like myocardial infarction and specific cancers.
- Recommends a high autopsy rate (86% in this study) for enhancing geriatric diagnostic precision.
- Provides valuable data for refining clinical practice and medical education in geriatrics and pathology.