[今日尸检：是过时的做法还是提高医疗质量的工具？]
[Autopsy today: an obsolete practice or an instrument for improving the quality of health care?].
作者信息
Panella M, Kozel D, Marchisio S, Sarasino D, Pavanello P P, Jussich G, Di Stanislao F
机构信息
Cattedra di Igiene, Università del Piemonte Orientale A. Avogadro, Facoltà di Medicina e Chirurgia di Novara.
出版信息
Pathologica. 2000 Apr;92(2):58-64.
INTRODUCTION
Autopsies are a fundamental moment of clinical audit that have been progressively decaying.
MATERIALS AND METHODS
The autoptic rates of 6 hospitals of Piedmont Region (1639 autopsies, years 1995-97) were calculated. The Positive Predictive Value and Sensitivity (indicators of concordance between clinical and autoptic diagnosis) were calculated for each diagnosis; all discrepancies were classified as type I (adverse impact on patient's survival) and type II (uncertain impact) clinical errors. The diagnostic performance of medical, surgical and emergency staffs were compared with one another.
RESULTS
Autopsies are rarely performed on the patients who died in hospital (7.13%). Independently from the diagnosis, the global concordance expresses a Positive Predictive Value of 37.22% and a Sensitivity of 47.71%. 401 type I errors and 307 type II errors were found. The best performance is reached by emergency staff.
AIM
To evaluate the use and the meaning of autopsies in today's Italian healthcare organisations.
引言
尸检是临床审计的一个基本环节，但目前其数量在逐渐减少。
材料与方法
计算了皮埃蒙特地区6家医院的尸检率（1995 - 1997年期间共1639例尸检）。针对每种诊断计算了阳性预测值和敏感度（临床诊断与尸检诊断一致性的指标）；所有差异被归类为I型（对患者生存有不利影响）和II型（影响不确定）临床错误。对内科、外科和急诊科医护人员的诊断表现进行了相互比较。
结果
在医院死亡的患者中很少进行尸检（7.13%）。无论诊断如何，总体一致性表现为阳性预测值为37.22%，敏感度为47.71%。发现了401例I型错误和307例II型错误。急诊科医护人员的表现最佳。
目的
评估在当今意大利医疗保健机构中尸检的用途及其意义。
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