Medical autopsy: whose gain is it? An audit.

Medical audit is essential in assessing the efficacy of health care delivery system. Though autopsy services are generally looked upon indifferently and with sceptism by the clinicians, it can form an important part of the medical audit system. The aims of this study were to audit autopsies of deaths within 24 hours of hospital admission by: 1) Comparing premortem and postmortem diagnosis; 2) Comparing postmortem gross diagnosis with postmortem histopathologic diagnosis; 3) Whether deaths could be certified based on clinical judgement and autopsies avoided. The study sample was 99 autopsies. In 45% autopsies, clinical impression did not match the final cause of death. In 14.2% autopsies, final cause of death could have been given by the clinician based on his clinical judgement. In 54.5% autopsies, there was agreement between premortem and postmortem diagnosis. In 67.6% autopsies, gross findings matched with the histopathologic findings.