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

Pathologists' opinions of cause of death given at the end of post-mortem (PM) reports have often been used to validate clinicians' death certificates. Information about strokes, common coincident conditions and complications in 120 full PM reports was compared with the pathologists' opinions of cause of death given at the end of the reports. Intracranial haemorrhage and myocardial infarction were mentioned as frequently in the cause of death as in the full PM report. On the other hand, cerebral infarction, precerebral artery occlusion, severe cerebral atheroma, coronary artery occlusion, bronchopneumonia and pulmonary embolism were all under-cited in the causes of death. Whether a pathological condition mentioned in the full PM report also appeared in the cause of death varied with the decedent's age, the extent of the condition and type of stroke. Consideration should be given to using all the information in PM reports rather than just pathologists' opinions of cause of death given at the end of PM reports when studying the validity of clinicians' death certificates.