Major discrepancy between clinical diagnosis of death and anatomopathological findings in adolescents with chronic diseases during 18-years
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , , , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Clinics |
Texto Completo: | https://www.revistas.usp.br/clinics/article/view/213716 |
Resumo: | Objectives: To evaluate the inconsistency between clinical diagnosis of death and autopsy findings in adolescents with chronic diseases. Methods: A cross-sectional study including a sample of adolescents’ autopsies who died in a pediatric and adolescent tertiary hospital over 18 consecutive years. During this period, there were n = 2912 deaths, and n = 581/2912(20%) occurred in adolescents. Of these, n = 85/581(15%) underwent autopsies and were analyzed. Further results were divided into two groups: Goldman classes I or II (high disagreement between main clinical diagnosis of death and anatomopathological findings, n = 26) and Goldman classes III, IV or V (low or no disagreement between these two parameters, n = 59). Results: Median age at death (13.5 [10‒19] vs. 13 [10‒19] years, p = 0.495) and disease duration (22 [0‒164] vs. 20 [0‒200] months, p = 0.931), and frequencies for males (58% vs. 44%, p = 0.247) were similar between class I/II vs. class III/IV/V. The frequency of pneumonia (73% vs. 48%, p = 0.029), pulmonary abscess (12% vs. 0%, p = 0.026), as well as isolation of yeast (27% vs. 5%, p = 0.008), and virus (15% vs. 2%, p = 0.029) identified in the autopsy, were significantly higher in adolescents with Goldman class I/II compared to those with Goldman class III/IV/V. In contrast, cerebral edema was significantly lower in adolescents of the first group (4% vs. 25%, p = 0.018). Conclusion: This study showed that 30% of the adolescents with chronic diseases had major discrepancies between clinical diagnosis of death and autopsy findings. Pneumonia, pulmonary abscess, as well as isolation of yeast and virus were more frequently identified at autopsy findings in the groups with major discrepancies. |
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Major discrepancy between clinical diagnosis of death and anatomopathological findings in adolescents with chronic diseases during 18-yearsAutopsyDeathAdolescentChronic diseasesPneumoniaYeastObjectives: To evaluate the inconsistency between clinical diagnosis of death and autopsy findings in adolescents with chronic diseases. Methods: A cross-sectional study including a sample of adolescents’ autopsies who died in a pediatric and adolescent tertiary hospital over 18 consecutive years. During this period, there were n = 2912 deaths, and n = 581/2912(20%) occurred in adolescents. Of these, n = 85/581(15%) underwent autopsies and were analyzed. Further results were divided into two groups: Goldman classes I or II (high disagreement between main clinical diagnosis of death and anatomopathological findings, n = 26) and Goldman classes III, IV or V (low or no disagreement between these two parameters, n = 59). Results: Median age at death (13.5 [10‒19] vs. 13 [10‒19] years, p = 0.495) and disease duration (22 [0‒164] vs. 20 [0‒200] months, p = 0.931), and frequencies for males (58% vs. 44%, p = 0.247) were similar between class I/II vs. class III/IV/V. The frequency of pneumonia (73% vs. 48%, p = 0.029), pulmonary abscess (12% vs. 0%, p = 0.026), as well as isolation of yeast (27% vs. 5%, p = 0.008), and virus (15% vs. 2%, p = 0.029) identified in the autopsy, were significantly higher in adolescents with Goldman class I/II compared to those with Goldman class III/IV/V. In contrast, cerebral edema was significantly lower in adolescents of the first group (4% vs. 25%, p = 0.018). Conclusion: This study showed that 30% of the adolescents with chronic diseases had major discrepancies between clinical diagnosis of death and autopsy findings. Pneumonia, pulmonary abscess, as well as isolation of yeast and virus were more frequently identified at autopsy findings in the groups with major discrepancies.Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2023-03-25info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/clinics/article/view/21371610.1016/j.clinsp.2023.100184Clinics; v. 78 (2023); .100184Clinics; Vol. 78 (2023); .100184Clinics; Vol. 78 (2023); .1001841980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/213716/195839Copyright (c) 2023 Clinicsinfo:eu-repo/semantics/openAccessRibeiro, Maira P.Duarte-Neto, Amaro N.Dolhnikoff, MarisaLindoso, LiviaLourenço, BenitoMarques, Heloisa H.Pereira, Maria F.B.Cristofani, Lilian M.Odone-Filho, VicenteCampos, Lucia M.A.Sallum, Adriana M.E.Carneiro-Sampaio, MagdaDelgado, Artur F.Carvalho, Werther B.Mauad, ThaisSilva, Clovis A.2023-06-27T13:17:53Zoai:revistas.usp.br:article/213716Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2023-06-27T13:17:53Clinics - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Major discrepancy between clinical diagnosis of death and anatomopathological findings in adolescents with chronic diseases during 18-years |
title |
Major discrepancy between clinical diagnosis of death and anatomopathological findings in adolescents with chronic diseases during 18-years |
spellingShingle |
Major discrepancy between clinical diagnosis of death and anatomopathological findings in adolescents with chronic diseases during 18-years Ribeiro, Maira P. Autopsy Death Adolescent Chronic diseases Pneumonia Yeast |
title_short |
Major discrepancy between clinical diagnosis of death and anatomopathological findings in adolescents with chronic diseases during 18-years |
title_full |
Major discrepancy between clinical diagnosis of death and anatomopathological findings in adolescents with chronic diseases during 18-years |
title_fullStr |
Major discrepancy between clinical diagnosis of death and anatomopathological findings in adolescents with chronic diseases during 18-years |
title_full_unstemmed |
Major discrepancy between clinical diagnosis of death and anatomopathological findings in adolescents with chronic diseases during 18-years |
title_sort |
Major discrepancy between clinical diagnosis of death and anatomopathological findings in adolescents with chronic diseases during 18-years |
author |
Ribeiro, Maira P. |
author_facet |
Ribeiro, Maira P. Duarte-Neto, Amaro N. Dolhnikoff, Marisa Lindoso, Livia Lourenço, Benito Marques, Heloisa H. Pereira, Maria F.B. Cristofani, Lilian M. Odone-Filho, Vicente Campos, Lucia M.A. Sallum, Adriana M.E. Carneiro-Sampaio, Magda Delgado, Artur F. Carvalho, Werther B. Mauad, Thais Silva, Clovis A. |
author_role |
author |
author2 |
Duarte-Neto, Amaro N. Dolhnikoff, Marisa Lindoso, Livia Lourenço, Benito Marques, Heloisa H. Pereira, Maria F.B. Cristofani, Lilian M. Odone-Filho, Vicente Campos, Lucia M.A. Sallum, Adriana M.E. Carneiro-Sampaio, Magda Delgado, Artur F. Carvalho, Werther B. Mauad, Thais Silva, Clovis A. |
author2_role |
author author author author author author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Ribeiro, Maira P. Duarte-Neto, Amaro N. Dolhnikoff, Marisa Lindoso, Livia Lourenço, Benito Marques, Heloisa H. Pereira, Maria F.B. Cristofani, Lilian M. Odone-Filho, Vicente Campos, Lucia M.A. Sallum, Adriana M.E. Carneiro-Sampaio, Magda Delgado, Artur F. Carvalho, Werther B. Mauad, Thais Silva, Clovis A. |
dc.subject.por.fl_str_mv |
Autopsy Death Adolescent Chronic diseases Pneumonia Yeast |
topic |
Autopsy Death Adolescent Chronic diseases Pneumonia Yeast |
description |
Objectives: To evaluate the inconsistency between clinical diagnosis of death and autopsy findings in adolescents with chronic diseases. Methods: A cross-sectional study including a sample of adolescents’ autopsies who died in a pediatric and adolescent tertiary hospital over 18 consecutive years. During this period, there were n = 2912 deaths, and n = 581/2912(20%) occurred in adolescents. Of these, n = 85/581(15%) underwent autopsies and were analyzed. Further results were divided into two groups: Goldman classes I or II (high disagreement between main clinical diagnosis of death and anatomopathological findings, n = 26) and Goldman classes III, IV or V (low or no disagreement between these two parameters, n = 59). Results: Median age at death (13.5 [10‒19] vs. 13 [10‒19] years, p = 0.495) and disease duration (22 [0‒164] vs. 20 [0‒200] months, p = 0.931), and frequencies for males (58% vs. 44%, p = 0.247) were similar between class I/II vs. class III/IV/V. The frequency of pneumonia (73% vs. 48%, p = 0.029), pulmonary abscess (12% vs. 0%, p = 0.026), as well as isolation of yeast (27% vs. 5%, p = 0.008), and virus (15% vs. 2%, p = 0.029) identified in the autopsy, were significantly higher in adolescents with Goldman class I/II compared to those with Goldman class III/IV/V. In contrast, cerebral edema was significantly lower in adolescents of the first group (4% vs. 25%, p = 0.018). Conclusion: This study showed that 30% of the adolescents with chronic diseases had major discrepancies between clinical diagnosis of death and autopsy findings. Pneumonia, pulmonary abscess, as well as isolation of yeast and virus were more frequently identified at autopsy findings in the groups with major discrepancies. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-03-25 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/213716 10.1016/j.clinsp.2023.100184 |
url |
https://www.revistas.usp.br/clinics/article/view/213716 |
identifier_str_mv |
10.1016/j.clinsp.2023.100184 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/213716/195839 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2023 Clinics info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2023 Clinics |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
dc.source.none.fl_str_mv |
Clinics; v. 78 (2023); .100184 Clinics; Vol. 78 (2023); .100184 Clinics; Vol. 78 (2023); .100184 1980-5322 1807-5932 reponame:Clinics instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Clinics |
collection |
Clinics |
repository.name.fl_str_mv |
Clinics - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
||clinics@hc.fm.usp.br |
_version_ |
1787713183939559424 |