Mazeikiene Sandra, Stasiuniene Jurgita, Vasiljevaite Diana, Laima Sigitas, Chmieliauskas Sigitas, Fomin Dmitrij, Simakauskas Rokas, Jasulaitis Algimantas
Department of Pathology, Forensic Medicine and Pharmacology, Institute of Biomedical Sciences of the Faculty of Medicine of Vilnius University, Vilnius, Lithuania.
Medicine (Baltimore). 2020 Jan;99(3):e18770. doi: 10.1097/MD.0000000000018770.
Discrepancies between clinical and autopsy diagnoses range from 30% to 37%. The significance of deontological examinations remains high. In the pursuit of proper evaluation of diagnostic discrepancies, the establishment of pathogenesis, the mechanism of death, and a correct diagnosis are of particular importance.A retrospective study of deontological examinations, aimed at the detection of medical errors and carried out by the State Forensic Medicine Service during the period 1989 to 2016, was performed. The clinical and autopsy data from 1007 cases were collected in compliance with the research protocol.The number of deontological examinations tends to increase. In 60% of cases, the deceased were men. Most cases were in the age group of 50 to 59 years. Most examinations were carried out in relation to improperly provided healthcare services and the patient's death in surgery, admission, intensive care and obstetrics-gynecology departments. In 13% of cases, the diagnosis did not coincide and, in 79% of cases, the diagnoses fully coincided. In 68% of cases, the medical error was disproved.The number of deontological examinations is increasing. In most cases, clinical and autopsy diagnoses fully matched. Incorrectly clinically diagnosed intracranial injuries were the most common diagnostic mistakes. The data are similar to the results of research in other countries and would be relevant to ensuring the prevention of medical mistakes and the improvement of healthcare quality.
临床诊断与尸检诊断之间的差异率在30%至37%之间。法医学检查的重要性依然很高。在追求对诊断差异进行恰当评估的过程中，明确发病机制、死亡机制以及做出正确诊断尤为重要。对1989年至2016年期间由国家法医学服务机构开展的旨在发现医疗差错的法医学检查进行了一项回顾性研究。按照研究方案收集了1007例病例的临床和尸检数据。法医学检查的数量呈上升趋势。60%的死者为男性。大多数病例年龄在50至59岁之间。大多数检查是针对医疗服务提供不当以及患者在外科、住院部、重症监护室和妇产科死亡的情况。13%的病例诊断不一致，79%的病例诊断完全一致。68%的病例医疗差错不成立。法医学检查的数量在增加。大多数情况下，临床诊断与尸检诊断完全相符。临床误诊的颅内损伤是最常见的诊断失误。这些数据与其他国家的研究结果相似，对于确保预防医疗差错和提高医疗质量具有参考价值。
