Jurić G, Tentor D, Jakić-Razumović J
Department of Pathology, Zagreb University Hospital Center, Kispaticeva 12, HR-10000 Zagreb, Croatia.
Croat Med J. 1999 Mar;40(1):71-6.
To determine the extent of agreement between clinical and autopsy findings.
A 14-year retrospective study (1982-1995) of autopsies from the Departments of Internal Medicine and Surgery was performed at the Zagreb University Hospital Center, Croatia. The autopsy findings were compared with the clinical diagnoses.
The autopsy rate among hospital deaths ranged between 23% and 33%. The overall rate of major discrepancies was 11.6% for all autopsy reports. The most common cause of death were cardiovascular diseases (40.9%), followed by malignancies (25.2%) and infections (12.9%). Among all cardiovascular diseases, myocardial infarction was the most frequently diagnosed (17.9%) and was misdiagnosed by clinicians in 16.5% of the cases. Incorrectly diagnosed malignancies were found in only 5.7% of the cases; hematological and lymphoid malignancies (48.8%) were the most common neoplasms and were usually confirmed before death. Infections were found in 46.9% of all autopsies. Bacterial pneumonias and peritonitis were overlooked in 67.5% and 23. 5% of the cases, respectively, in which they existed together with another serious condition.
Modern technology has not improved the overall accuracy of clinical diagnoses. When an autopsy should be performed is still a matter of discussion.
确定临床检查结果与尸检结果之间的一致程度。
在克罗地亚萨格勒布大学医院中心，对内科学和外科学系1982年至1995年期间的尸检进行了一项为期14年的回顾性研究。将尸检结果与临床诊断进行比较。
医院死亡病例中的尸检率在23%至33%之间。所有尸检报告中主要差异的总体发生率为11.6%。最常见的死亡原因是心血管疾病（40.9%），其次是恶性肿瘤（25.2%）和感染（12.9%）。在所有心血管疾病中，心肌梗死的诊断最为频繁（17.9%），临床医生误诊的病例占16.5%。仅5.7%的病例中发现恶性肿瘤诊断错误；血液系统和淋巴系统恶性肿瘤（48.8%）是最常见的肿瘤类型，通常在死亡前得到确诊。在所有尸检中，46.9%发现有感染。细菌性肺炎和腹膜炎在分别与其他严重病症并存的病例中，被漏诊的比例分别为67.5%和23.5%。
现代技术并未提高临床诊断的总体准确性。何时应进行尸检仍是一个有争议的问题。
