Discrepancies between clinical diagnoses and autopsy findings
Autor(a) principal: | |
---|---|
Data de Publicação: | 2003 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.1590/S0100-879X2003000300014 http://hdl.handle.net/11449/13062 |
Resumo: | Autopsy examination is considered to be an essential element for medical auditing and teaching. Despite the significant progress in diagnostic procedures, autopsy has not always confirmed the clinical diagnosis. In the present study, we compared the diagnosis recorded on medical charts with reports of 96 autopsies performed at the University Teaching Hospital of the Faculdade de Medicina de Botucatu, Botucatu, SP, Brazil, between 1975 and 1982, and of 156 autopsies performed at the same institution between 1992 and 1996. The clinical diagnosis of the basic cause of death was confirmed at autopsy in 77% of cases. The percent confirmation fell to 60% when the immediate terminal cause of death was considered, and in 25% of cases, the terminal cause was only diagnosed at autopsy. The discrepancies between clinical and autopsy diagnosis were even larger for secondary diagnoses: 50% of them were not suspected upon clinical diagnosis. Among them, we emphasize the diagnosis of venous thromboses (83%), pulmonary embolisms (80%), bronchopneumonias (46%) and neoplasias (38%). Iatrogenic injuries were very frequent, and approximately 90% of them were not described in clinical reports. Our results suggest that highly sensitive and specific diagnostic tests are necessary but cannot substitute the clinical practice for the elaboration of correct diagnoses. |
id |
UNSP_589fca9f0fcfef1104b20c67c3c4f15c |
---|---|
oai_identifier_str |
oai:repositorio.unesp.br:11449/13062 |
network_acronym_str |
UNSP |
network_name_str |
Repositório Institucional da UNESP |
repository_id_str |
2946 |
spelling |
Discrepancies between clinical diagnoses and autopsy findingsAutopsy diagnosisClinical diagnosisIatrogenic injuriesAutopsy examination is considered to be an essential element for medical auditing and teaching. Despite the significant progress in diagnostic procedures, autopsy has not always confirmed the clinical diagnosis. In the present study, we compared the diagnosis recorded on medical charts with reports of 96 autopsies performed at the University Teaching Hospital of the Faculdade de Medicina de Botucatu, Botucatu, SP, Brazil, between 1975 and 1982, and of 156 autopsies performed at the same institution between 1992 and 1996. The clinical diagnosis of the basic cause of death was confirmed at autopsy in 77% of cases. The percent confirmation fell to 60% when the immediate terminal cause of death was considered, and in 25% of cases, the terminal cause was only diagnosed at autopsy. The discrepancies between clinical and autopsy diagnosis were even larger for secondary diagnoses: 50% of them were not suspected upon clinical diagnosis. Among them, we emphasize the diagnosis of venous thromboses (83%), pulmonary embolisms (80%), bronchopneumonias (46%) and neoplasias (38%). Iatrogenic injuries were very frequent, and approximately 90% of them were not described in clinical reports. Our results suggest that highly sensitive and specific diagnostic tests are necessary but cannot substitute the clinical practice for the elaboration of correct diagnoses.Hospital Amaral Carvalho Departamento de Hematologia e Oncologia ClínicaUniversidade de São Paulo Faculdade de Medicina Departamento de CardiologiaUniversidade Estadual Paulista Faculdade de Medicina de Botucatu Departamento de PatologiaUniversidade Estadual Paulista Faculdade de Medicina de Botucatu Departamento de PatologiaAssociação Brasileira de Divulgação Científica (ABRADIC)Hospital Amaral Carvalho Departamento de Hematologia e Oncologia ClínicaUniversidade de São Paulo (USP)Universidade Estadual Paulista (Unesp)Coradazzi, A.L.Morganti, A.L.C.Montenegro, M.R.G. [UNESP]2014-05-20T13:37:40Z2014-05-20T13:37:40Z2003-03-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article385-391application/pdfhttp://dx.doi.org/10.1590/S0100-879X2003000300014Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 36, n. 3, p. 385-391, 2003.0100-879Xhttp://hdl.handle.net/11449/1306210.1590/S0100-879X2003000300014S0100-879X2003000300014S0100-879X2003000300014.pdfSciELOreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengBrazilian Journal of Medical and Biological Research1.492info:eu-repo/semantics/openAccess2024-01-14T06:17:37Zoai:repositorio.unesp.br:11449/13062Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462024-01-14T06:17:37Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
Discrepancies between clinical diagnoses and autopsy findings |
title |
Discrepancies between clinical diagnoses and autopsy findings |
spellingShingle |
Discrepancies between clinical diagnoses and autopsy findings Coradazzi, A.L. Autopsy diagnosis Clinical diagnosis Iatrogenic injuries |
title_short |
Discrepancies between clinical diagnoses and autopsy findings |
title_full |
Discrepancies between clinical diagnoses and autopsy findings |
title_fullStr |
Discrepancies between clinical diagnoses and autopsy findings |
title_full_unstemmed |
Discrepancies between clinical diagnoses and autopsy findings |
title_sort |
Discrepancies between clinical diagnoses and autopsy findings |
author |
Coradazzi, A.L. |
author_facet |
Coradazzi, A.L. Morganti, A.L.C. Montenegro, M.R.G. [UNESP] |
author_role |
author |
author2 |
Morganti, A.L.C. Montenegro, M.R.G. [UNESP] |
author2_role |
author author |
dc.contributor.none.fl_str_mv |
Hospital Amaral Carvalho Departamento de Hematologia e Oncologia Clínica Universidade de São Paulo (USP) Universidade Estadual Paulista (Unesp) |
dc.contributor.author.fl_str_mv |
Coradazzi, A.L. Morganti, A.L.C. Montenegro, M.R.G. [UNESP] |
dc.subject.por.fl_str_mv |
Autopsy diagnosis Clinical diagnosis Iatrogenic injuries |
topic |
Autopsy diagnosis Clinical diagnosis Iatrogenic injuries |
description |
Autopsy examination is considered to be an essential element for medical auditing and teaching. Despite the significant progress in diagnostic procedures, autopsy has not always confirmed the clinical diagnosis. In the present study, we compared the diagnosis recorded on medical charts with reports of 96 autopsies performed at the University Teaching Hospital of the Faculdade de Medicina de Botucatu, Botucatu, SP, Brazil, between 1975 and 1982, and of 156 autopsies performed at the same institution between 1992 and 1996. The clinical diagnosis of the basic cause of death was confirmed at autopsy in 77% of cases. The percent confirmation fell to 60% when the immediate terminal cause of death was considered, and in 25% of cases, the terminal cause was only diagnosed at autopsy. The discrepancies between clinical and autopsy diagnosis were even larger for secondary diagnoses: 50% of them were not suspected upon clinical diagnosis. Among them, we emphasize the diagnosis of venous thromboses (83%), pulmonary embolisms (80%), bronchopneumonias (46%) and neoplasias (38%). Iatrogenic injuries were very frequent, and approximately 90% of them were not described in clinical reports. Our results suggest that highly sensitive and specific diagnostic tests are necessary but cannot substitute the clinical practice for the elaboration of correct diagnoses. |
publishDate |
2003 |
dc.date.none.fl_str_mv |
2003-03-01 2014-05-20T13:37:40Z 2014-05-20T13:37:40Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1590/S0100-879X2003000300014 Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 36, n. 3, p. 385-391, 2003. 0100-879X http://hdl.handle.net/11449/13062 10.1590/S0100-879X2003000300014 S0100-879X2003000300014 S0100-879X2003000300014.pdf |
url |
http://dx.doi.org/10.1590/S0100-879X2003000300014 http://hdl.handle.net/11449/13062 |
identifier_str_mv |
Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 36, n. 3, p. 385-391, 2003. 0100-879X 10.1590/S0100-879X2003000300014 S0100-879X2003000300014 S0100-879X2003000300014.pdf |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Brazilian Journal of Medical and Biological Research 1.492 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
385-391 application/pdf |
dc.publisher.none.fl_str_mv |
Associação Brasileira de Divulgação Científica (ABRADIC) |
publisher.none.fl_str_mv |
Associação Brasileira de Divulgação Científica (ABRADIC) |
dc.source.none.fl_str_mv |
SciELO reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
|
_version_ |
1792962333848371200 |