Xiao Jianguo, Krueger Gerhard R F, Buja L Maximilian, Covinsky Michael
Department of Pathology and Laboratory Medicine, UT-Houston Medical School, Houston, Texas 77030, USA.
Am J Med Sci. 2009 Jan;337(1):41-6. doi: 10.1097/MAJ.0b013e318184ce2b.
In Western countries, autopsy rates for patients deceased in hospitals have dropped to record lows, while the average frequency of major errors in clinical diagnoses has more than doubled during the same time period. Meanwhile, the Institute of Medicine and the U.S. Department of Health and Human Services have called attention to the high frequency of errors affecting patient safety, bringing the issue of public safety to the forefront of public health concerns. Although autopsies represent a vital tool for the acquisition of new medical knowledge and for medical quality assurance, health care professionals, insurers, and politicians apparently have not chosen the right approach to solve the problem of declining autopsy rates. The present article reviews the current status of clinical autopsies and addresses causes and consequences of their neglect and appeal the urgent need to revise the policy for clinical autopsy.
在西方国家，医院死亡患者的尸检率已降至历史最低点，而在此期间临床诊断中的重大错误平均发生率增加了一倍多。与此同时，美国医学研究所和美国卫生与公众服务部已提请人们注意影响患者安全的错误高发问题，将公共安全问题推到了公共卫生关注的前沿。尽管尸检是获取新医学知识和保证医疗质量的重要工具，但医疗保健专业人员、保险公司和政界人士显然没有选择正确的方法来解决尸检率下降的问题。本文回顾了临床尸检的现状，探讨了忽视尸检的原因和后果，并呼吁迫切需要修订临床尸检政策。
