Erlmeier F, Weichert W, Knüchel R, Andruszkow J
Institut für Pathologie, Technische Universität München, Trogerstr. 18, 81675, München, Deutschland.
Deutsches Konsortium für Translationale Krebsforschung, Heidelberg, Deutschland.
Pathologe. 2017 Sep;38(5):430-437. doi: 10.1007/s00292-017-0319-4.
The clinical autopsy is the ultimate medical service for a patient and plays a crucial role in the education of physicians and other medical personnel, as well as in the context of quality control. Nevertheless, the number of autopsies is constantly decreasing. Numerous factors, such as the personal attitude of relatives and also clarification of relatives, as well as the increasing application of imaging methods while the patient is still alive, play a central role in this decline.
This study aimed to demonstrate the development of autopsy services over the past decade in two university hospitals in Germany and therefore to underline the importance of this investigation procedure in pathology.
Autopsy reports between the years 2005 and 2014 from 2 university institutes of pathology were analyzed regarding a diverse dataset, including age and sex of the deceased as well as the clinical and pathological causes of death.
The data showed that the number of autopsies has continuously decreased over the past decade; however, the distribution of characteristics of the deceased remained relatively stable. In this cohort the clinically assumed cause of death differed from the pathological cause of death in 6% of the autopsies. Frequently occurring discrepant diagnoses were cardiac tamponade, aortic dissection and endocarditis/myocarditis.
Our results show that, despite significant improvements in imaging methods, findings do not yield more accurate results than does autopsy. This underscores once again the need to encourage the performance of this final medical act on patients.
临床尸检是为患者提供的终极医疗服务,在医师及其他医务人员的培训以及质量控制方面发挥着关键作用。然而,尸检数量却在持续减少。诸多因素,诸如亲属的个人态度及亲属的说明,以及患者生前成像方法应用的增加,在这一下降趋势中起着核心作用。
本研究旨在展示德国两家大学医院过去十年尸检服务的发展情况,从而强调这一病理检查程序的重要性。
分析了2005年至2014年间来自两所大学病理研究所的尸检报告,涉及一个多样的数据集,包括死者的年龄和性别以及临床和病理死因。
数据显示,在过去十年中尸检数量持续减少;然而,死者特征的分布保持相对稳定。在该队列中,6%的尸检中临床假定的死因与病理死因不同。常见的诊断差异包括心脏压塞、主动脉夹层和心内膜炎/心肌炎。
我们的结果表明,尽管成像方法有显著改进,但与尸检相比,其结果并不更准确。这再次强调了鼓励对患者进行这一最终医疗行为的必要性。