Departamento de Patología, Universidad Remington, Medellín, Colombia.
Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia; Facultad de Ciencias de la Salud, Universidad ICESI, Cali, Colombia; División de Traumatología y Cirugía de Cuidados Intensivos, Departamento de Cirugía, Universidad del Valle, Cali, Colombia.
Biomedica. 2024 Nov 6;44(4):486-495. doi: 10.7705/biomedica.7097.
A clinical autopsy is a fundamental diagnostic tool for confirming the diagnosis of diseases of public health interest. However, the clinical-pathological concordance has not been evaluated.
To determine the concordance between clinical diagnoses and anatomopathological findings from autopsies conducted at a tertiary-level hospital institution.
A descriptive, observational, cross-sectional, and retrospective study where we analyzed autopsy cases performed between 2015 and 2019. The variables studied were age, gender, origin, and clinical and anatomopathological diagnoses.
The concordance degree was slight (κ = 0.30; 95% CI: 0.21-0.42), which coincides with internationally reported findings in healthcare institutions with a similar patient population and availability of diagnostic resources. The clinical-pathological discrepancy, as evidenced according to the Goldman et al. classification, then modified by Battle et al., was 57.3% (47/82), corresponding to major discrepancies, a value within the expected limits.
The concordance between clinical diagnoses and anatomopathological findings in autopsies is slight, and the discrepancies are within the expected range. This study highlights the importance of improving clinical and syndromic diagnosis of public health interest.
临床尸检是确认具有公共卫生意义的疾病诊断的基本诊断工具。然而，临床-病理一致性尚未得到评估。
确定在三级医院机构进行的尸检中临床诊断与解剖病理学发现之间的一致性。
这是一项描述性、观察性、横断面和回顾性研究，我们分析了 2015 年至 2019 年期间进行的尸检病例。研究的变量包括年龄、性别、来源以及临床和解剖病理学诊断。
一致性程度较低（κ = 0.30；95%CI：0.21-0.42），与国际上报告的具有相似患者人群和诊断资源可用性的医疗机构的发现一致。根据 Goldman 等人的分类以及后来由 Battle 等人修改的分类，临床-病理差异为 57.3%（47/82），对应主要差异，这是预期范围内的值。
尸检中临床诊断与解剖病理学发现之间的一致性较低，差异在预期范围内。这项研究强调了提高对具有公共卫生意义的临床和综合征诊断的重要性。
