Gradistanac T, Wittekind C
Institut für Pathologie, Universitätsklinikum Leipzig - AöR, Liebigstrasse 26, 04103, Leipzig, Deutschland.
Pathologe. 2011 Nov;32 Suppl 2:287-91. doi: 10.1007/s00292-011-1466-7.
Autopsy rates have declined throughout the world although autopsy serves as an important tool in quality management. Working together with the Department of Heart Surgery of the Heart Centre in Leipzig clinical and autopsy diagnoses were compared. Between 2000 and 2003 an autopsy was performed in 468 patients. Data from clinical and postmortem examinations were prospectively analysed regarding causes of death, concomitant diseases and postoperative complications. Discrepancies between clinical and postmortem cause of death were identified in 23.1% of these patients. In 99.1% of the patients concomitant diseases (e.g. myocardial hypertrophy, pulmonary embolism, former stroke) could be identified, 57.6% were unknown pre-mortem and 19.2% were considered to be of relevance for surgical therapy. Autopsy is the final and most comprehensive physical examination. Autopsy is also the basis of training for pathologists in interpreting interrelated diagnoses. Therefore the task of pathologists is to enhance the appreciation of autopsy among clinical colleagues by working closely side by side. By communication an autopsy can deliver an effective achievement in terms of being relevant for praxis.
尽管尸检是质量管理的一项重要工具，但全世界的尸检率都在下降。我们与莱比锡心脏中心心脏外科合作，对临床诊断和尸检诊断进行了比较。2000年至2003年期间，对468例患者进行了尸检。对临床和尸检检查的数据进行了前瞻性分析，内容包括死亡原因、伴随疾病和术后并发症。在这些患者中，23.1%的患者临床和尸检的死亡原因存在差异。在99.1%的患者中，可以确定伴随疾病（如心肌肥厚、肺栓塞、既往中风），其中57.6%在死前未知，19.2%被认为与手术治疗相关。尸检是最终也是最全面的体格检查。尸检也是病理学家解读相关诊断的培训基础。因此，病理学家的任务是通过与临床同事紧密合作，提高他们对尸检的重视程度。通过沟通，尸检在实践相关性方面可以取得有效的成果。
