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An evaluation of autopsy review as a technique for infection control: a procedure of questionable value
Abstract:
Review of necropsy reports for evidence of undiagnosed antemortem infection is included by the Joint Commission on Accreditation of Hospitals as an element of an effective hospital infection control program. We reviewed records of 155 patients autopsied at St. Paul-Ramsey Medical Center between January 1, 1980 and March 31, 1981. In 13 patients (8%), there was a discrepancy between documentation of infection during the patient's hospitalization and at autopsy. However, in none of these cases was this information useful in our infection control program. We doubt the effectiveness of necropsy review as a tool for nosocomial infection control.
Insights
Necropsy review for hospital infection control is mandated but rarely useful. This study found discrepancies in 8% of cases, yet this data did not improve infection control efforts.
Area of Science:
- Hospital infection control
- Medical diagnostics
- Pathology
Background:
- The Joint Commission mandates necropsy report review for hospital infection control.
- Undiagnosed antemortem infections identified at autopsy are a key focus.
Purpose of the Study:
- To evaluate the effectiveness of necropsy report review in identifying and controlling nosocomial infections.
Main Methods:
- Retrospective review of 155 patient autopsy records from St. Paul-Ramsey Medical Center (January 1980 - March 1981).
- Analysis of discrepancies between antemortem infection documentation and autopsy findings.
Main Results:
- Discrepancies were found in 13 patients (8%).
- The identified discrepancies did not contribute to the hospital's infection control program.
Conclusions:
- Necropsy review, as implemented, is unlikely to be an effective tool for nosocomial infection control.
- Current practices may not yield actionable insights for improving patient safety regarding hospital-acquired infections.