Medical autopsies after deaths outside hospital.

BACKGROUND

Little is known about which cases of death outside hospital are currently investigated by way of a medical (clinical) autopsy. Against this background, medical autopsies after death outside hospital that were performed at the Department of Pathology, Akershus University Hospital, are presented in this article.

MATERIAL AND METHOD

Medical autopsies performed after deaths occurring outside hospital in the years 2007-11 were reviewed. Age, gender, type of requisitioning agent, time of death (first or second half of the year), mode of death and clinical information were noted. The autopsy result was translated into ICD-10 codes (International Classification of Diseases, version 10). Information on the number of autopsies of deaths that occurred outside hospital in Norway in the period 2007-2010 was retrieved from the Cause of Death Registry.

RESULTS

In the period in question, Akershus University Hospital performed a total of 89 medical autopsies after deaths that occurred outside hospital. The deceased included 60 men and 29 women, with a median age of 58.5 and 60 years respectively. The annual number increased from 13 in 2007 to 26 in 2011, and tended to increase towards the end of the year. Figures from the Cause of Death Registry showed that the number of autopsies after deaths that occurred outside hospital also increased nationwide. The most frequent causes of death included cardiovascular diseases, external causes or alcoholism. Forensic toxicological examination contributed to the result in 34 of 43 investigations, and revealed three suicides.

INTERPRETATION

Medical autopsies after deaths outside hospital differed from autopsies undertaken after deaths that had occurred in hospital. The increase in autopsies undertaken after deaths outside hospital must be seen in the context of the increase in the total number of such deaths. The fact that more requisitions for autopsies are made in the latter half of the year may indicate that restricted budgets for forensic post mortems have caused medical autopsies to be requested to clarify the cause of death instead.