Academic Medical Center Amsterdam, University of Amsterdam, Amsterdam, Netherlands.
Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Room G2-231, Meibergdreef 9, Amsterdam, the Netherlands.
Int J Legal Med. 2020 Jul;134(4):1457-1463. doi: 10.1007/s00414-019-02219-6. Epub 2019 Dec 18.
The aim of this study was to investigate whether post-mortem computed tomography (PMCT) provides additional information regarding the cause of death and underlying diseases in a general practitioners' (GP), out-of-hospital population.
Bodies donated to our anatomy department between January 2014 and January 2018, who consecutively underwent a total body PMCT and had given permission for retrieval of their medical records during life, were included. PMCT scans were assessed by a radiologist and compared with the cause of death as stated in the medical records. Discrepancies were analyzed with an adjusted Goldman classification.
Ninety-three out of the 274 scanned donors during the inclusion period had given consent for the retrieval of their medical records, of which 79 GP's responded to the request thereof (31 men, 48 women, average age 72.8 years, range 36-99). PMCT identified 49 (62%) cases of cancer, 10 (12.7%) cardiovascular diseases, 8 (10.1%) severe organ failures, 5 (6.3%) cases with signs of pneumonia, 2 (2.5%) other causes, and 7 (8.9%) cases without an (underlying) definitive cause of death. Eleven major discrepancies on the Goldman classification scale, with possible relevance to survival between PMCT and GP records, were identified.
PMCT can have added value for the detection of additional findings regarding the cause of death in an out-of-hospital, GP's population, especially to identify or exclude major (previously non-diagnosed) underlying diseases.
本研究旨在探讨尸检计算机断层扫描（PMCT）是否能为全科医生（GP）院外人群的死因和潜在疾病提供额外信息。
纳入 2014 年 1 月至 2018 年 1 月期间捐赠给我们解剖部门并接受全身 PMCT 检查且生前同意检索其病历的尸体。由放射科医生评估 PMCT 扫描，并将其与病历中记载的死因进行比较。对差异采用调整后的 Goldman 分类进行分析。
在纳入期间接受扫描的 274 名捐赠者中，有 93 名同意检索其病历，其中 79 名 GP 对检索请求做出了回应（31 名男性，48 名女性，平均年龄 72.8 岁，范围 36-99 岁）。PMCT 发现 49 例（62%）癌症、10 例（12.7%）心血管疾病、8 例（10.1%）严重器官衰竭、5 例（6.3%）肺炎征象、2 例（2.5%）其他原因和 7 例（8.9%）无明确（潜在）死因的病例。在 Goldman 分类量表上发现了 11 个主要差异，PMCT 与 GP 记录之间可能与生存相关。
PMCT 可为院外 GP 人群死因的附加发现提供额外价值，特别是可以识别或排除主要（以前未诊断出的）潜在疾病。
