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Deaths and necropsies in a thoracic unit
D A Boldy1, C Jones, H Matthews
1Department of Respiratory Medicine, East Birmingham Hospital, Bordesley Green East.
Thorax
|March 1, 1993
Summary
Necropsies (post-mortem examinations) are valuable for uncovering unexpected diagnoses. While requests are reasonable, their justification lacks consistency, necessitating guidelines for improvement.
Area of Science:
- Medical diagnostics
- Pathology
- Clinical practice
Background:
- Growing concern over declining necropsy request rates.
- Need to evaluate current clinical practices regarding post-mortem examinations.
Purpose of the Study:
- To assess the current clinical practice of requesting and performing necropsies.
- To identify factors influencing necropsy request consistency.
Main Methods:
- Prospective study of deaths under chest physicians and thoracic surgeons.
- Data collection on necropsy requests and outcomes over a defined period.
Main Results:
- Necropsy sought in 59% of deaths, performed in 38%.
- Major unexpected findings occurred in 14% of necropsies.
- Significant delays in histological result reporting were observed, later improved by operational changes.
Conclusions:
- Necropsies remain crucial for identifying unsuspected diagnoses.
- Necropsy request rationale is inconsistent among clinicians.
- Development of guidelines is recommended to enhance necropsy request success and data yield.