Determinants of the autopsy decision: a statistical analysis

¹Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA.

|August 1, 1997

Summary

Autopsy rates are influenced by factors like age, cause of death, and location. Understanding these determinants is key to preserving the autopsy

Area of Science:

Background:

Autopsy rates have been declining, impacting clinical medicine and public health.
Identifying factors influencing autopsy decisions is crucial for developing strategies to maintain their utility.
Understanding autopsy determinants is a prerequisite for exploring cost-effective alternatives.

Purpose of the Study:

To conduct a multivariable statistical analysis of factors influencing autopsy decisions.
To identify key determinants of autopsy performance using national mortality data.
To provide insights for preserving the value of autopsies in specific circumstances.

Main Methods:

Utilized cross-sectional national mortality data from 1986.
Employed multiple logistic regression analysis on 139,063 individual mortality records.
Analyzed data state-by-state, estimating odds ratios for explanatory variables.

Main Results:

Factors positively associated with autopsies included male sex, nonwhite ethnicity, death from unknown/ill-defined causes, accidental/suicidal/homicidal deaths, proximity to medical centers, and urban location.
Factors negatively associated with autopsies included older age, higher income, death in nursing homes/at home, and rural residency.
Age at death (particularly advanced age) and death from accident, homicide, or suicide were the most significant predictors.

Conclusions:

Autopsy decisions are significantly influenced by demographic, socioeconomic, and cause-of-death variables.
Older age and deaths from external causes (accident, suicide, homicide) are strong predictors for autopsy performance.
Findings provide a basis for targeted interventions to support autopsies where they remain critical.

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