Information about strokes lost between post-mortem and reported cause of death

Area of Science:

• Forensic Pathology
• Clinical Pathology
• Medical Record Analysis

Background:

• Clinicians' death certificates are often validated against pathologists' stated causes of death from post-mortem (PM) reports.
• The accuracy of this validation relies on the completeness of information captured in the final cause of death summary.

Purpose of the Study:

• To compare the information on strokes, comorbidities, and complications in full PM reports with the pathologists' final opinions on the cause of death.
• To identify discrepancies in the reporting of pathological conditions between the full PM report and the summarized cause of death.

Main Methods:

• A comparative analysis of 120 full post-mortem reports and their corresponding pathologists' opinions on the cause of death.
• Detailed review of information regarding strokes, coincident conditions, and complications within the full PM reports.

Main Results:

• Intracranial hemorrhage and myocardial infarction were consistently reported in both full PM reports and causes of death.
• Cerebral infarction, precerebral artery occlusion, severe cerebral atheroma, coronary artery occlusion, bronchopneumonia, and pulmonary embolism were significantly under-reported in the causes of death.
• The concordance of pathological conditions between full reports and causes of death varied based on patient age, condition severity, and stroke type.

Conclusions:

• Pathologists' final opinions on cause of death may not fully represent all significant pathological findings detailed in the full post-mortem report.
• Relying solely on the summarized cause of death may lead to an incomplete understanding of contributing factors, potentially affecting death certificate validation.
• Future studies validating death certificates should consider utilizing the comprehensive data within full PM reports, not just the final stated cause of death.