Balaguer Martínez J V, Gabriel Botella F, Braso Aznar J V, Núñez Sánchez C, Catalá Barceló T, Labios Gómez M
Unidad de urgencias, Hospital Clinic Universitari de Valencia.
An Med Interna. 1998 Apr;15(4):179-82.
A total of 61 autopsies performed in patients died in emergency department of a university hospital were retrospectively analysed and the findings were compared with clinical diagnoses.
Sensitivity and specificity of the clinical diagnoses and the correction of medical procedures were measured. The influence of age and sex of patients was analyzed using Fisher's exact test and chi-square-test.
The most common causes of death were cardiovascular diseases (52.46%). Autopsy showed unexpected major findings in 44.26% of cases. Major discrepancies between the autopsy reports and the clinical diagnoses, were present in 26.22% of all cases. Absolute concordance between clinical and autopsy diagnoses was obtained in 44.26% of cases. The major sensitivity of clinical diagnosis was found in cerebrovascular disorders (100%), upper digestive hemorrhage (100%), and acute myocardial infarction (82.35%). The lowest sensitivity was found in malignant tumors (16.66%), hemorrhagic pancreatitis (0%) and bowel infarction (0%). The patient cares were correct in 68.85% of cases. No statistically significant differences were observed in relation to age and sex.
We concluded that autopsy is a useful method for evaluate diagnostic procedures and quality of medical cares in emergency departments.
回顾性分析一所大学医院急诊科61例死亡患者的尸检情况，并将结果与临床诊断进行比较。
测量临床诊断的敏感性和特异性以及医疗程序的正确性。采用Fisher精确检验和卡方检验分析患者年龄和性别的影响。
最常见的死亡原因是心血管疾病（52.46%）。尸检显示44.26%的病例有意外的主要发现。尸检报告与临床诊断之间的主要差异存在于所有病例的26.22%中。44.26%的病例临床诊断与尸检诊断完全一致。临床诊断的主要敏感性见于脑血管疾病（100%）、上消化道出血（100%）和急性心肌梗死（82.35%）。敏感性最低的是恶性肿瘤（16.66%）、出血性胰腺炎（0%）和肠梗死（0%）。68.85%的病例医疗护理正确。在年龄和性别方面未观察到统计学上的显著差异。
我们得出结论，尸检是评估急诊科诊断程序和医疗护理质量的一种有用方法。
