Quality control in fatally injured patients: the value of the necropsy.

OBJECTIVE

To identify the contribution of necropsy results to the audit care of severely injured patients.

DESIGN

Retrospective study.

SETTING

University Hospital in The Netherlands.

SUBJECTS

56 patients who died of severe trauma or its complications during the 10 year period, 1977 to 1987.

MAIN OUTCOME MEASURES

Correlation between clinical and necropsy findings.

RESULTS

The clinical and necropsy findings corresponded in 31 patients (55%). The necropsy brought to light errors in diagnosis or treatment that might have affected survival in eight cases (14%). The most common missed diagnoses were bronchopneumonia and severe haemorrhage, and the most common cause of death was sepsis. Age, length of stay in hospital, and time between admission and operation were not correlated with accuracy of diagnosis or adequacy of treatment.

CONCLUSION

Necropsies in patients who die after severe injuries make a useful contribution to the audit of the care of patients admitted with such injuries.