Fares Aline Fusco, Cury Patrícia Maluf, Lobo Suzana Margareth
Rev Bras Ter Intensiva. 2011 Dec;23(4):442-7.
The importance of autopsies is a common theme of discussions both in Brazil and around the world as it elucidates causes of death and has wide ranging social value. However this is a practice that is gradually being considered unnecessary and there have been a decline in the number of postmortems examinations.
To compare clinical and pathological diagnosis in critically ill patients with difficult premortem diagnosis.
All autopsy cases (total of 98) from any of the three general medical/surgical intensive care units (78 beds in total) affiliated to the medical school from January 2003 to December 2006 were analyzed. We analyzed the clinical and pathological diagnosis based on the Goldman criteria.
In 49 (50%) cases, there were class I and II of Goldman. In contrast, only 30 (30.6%) had a complete agreement between premortem and postmortem diagnosis and were classified as class V. Infections had a significantly greater rate of concordant diagnosis than cardiovascular diseases.
We found significant discrepancies between clinical and pathological findings, reinforcing the value of postmortem examination.
尸检的重要性是巴西乃至全球讨论的一个共同主题，因为它能阐明死因且具有广泛的社会价值。然而，这种做法正逐渐被认为没有必要，尸检数量也有所下降。
比较临终前诊断困难的重症患者的临床诊断与病理诊断。
分析了2003年1月至2006年12月医学院附属的三个普通内科/外科重症监护病房（共78张床位）的所有尸检病例（共98例）。我们根据戈德曼标准分析了临床诊断和病理诊断。
49例（50%）病例符合戈德曼一级和二级标准。相比之下，只有30例（30.6%）生前诊断与死后诊断完全一致，被归类为五级。感染的诊断一致性率明显高于心血管疾病。
我们发现临床和病理结果之间存在显著差异，这进一步证明了尸检的价值。
