Yu Lin-Sheng, Ye Guang-Hua, Fan Yan-Yan, Li Xing-Biao, Feng Xiang-Ping, Han Jun-Ge, Lin Ke-Zhi, Deng Miao-Wu, Li Feng
Department of Forensic Medicine, Wenzhou Medical University, 82 Wenzhou West College Road, Wenzhou, Zhejiang Province, 325035, P. R., China.
Institute of Forensic Science, Wenzhou Medical University, 82 Wenzhou West College Road, Wenzhou, Zhejiang Province, 325035, P. R., China.
J Forensic Sci. 2015 Sep;60(5):1212-5. doi: 10.1111/1556-4029.12769. Epub 2015 Apr 30.
Despite advances in medical science, the causes of death can sometimes only be determined by pathologists after a complete autopsy. Few studies have investigated the importance of forensic autopsy in medically disputed cases among different levels of institutional settings. Our study aimed to analyze forensic autopsy in 120 cases of medical disputes among five levels of institutional settings between 2001 and 2012 in Wenzhou, China. The results showed an overall concordance rate of 55%. Of the 39% of clinically missed diagnosis, cardiovascular pathology comprises 55.32%, while respiratory pathology accounts for the remaining 44. 68%. Factors that increase the likelihood of missed diagnoses were private clinics, community settings, and county hospitals. These results support that autopsy remains an important tool in establishing causes of death in medically disputed case, which may directly determine or exclude the fault of medical care and therefore in helping in resolving these cases.
尽管医学科学不断进步，但有时死亡原因只有在进行完整尸检后才能由病理学家确定。很少有研究调查法医尸检在不同级别医疗机构中医疗纠纷案件中的重要性。我们的研究旨在分析2001年至2012年期间中国温州五个级别医疗机构中120例医疗纠纷案件的法医尸检情况。结果显示总体符合率为55%。在临床漏诊的39%中，心血管病理占55.32%，而呼吸病理占其余的44.68%。增加漏诊可能性的因素包括私人诊所、社区医疗机构和县医院。这些结果支持尸检仍然是确定医疗纠纷案件死亡原因的重要工具，这可能直接确定或排除医疗过失，从而有助于解决这些案件。
