Evaluation of the discrepancy between clinical diagnostic hypotheses and anatomopathological diagnoses resulting from autopsies
Main Author: | |
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Publication Date: | 2019 |
Other Authors: | , |
Format: | Article |
Language: | eng |
Source: | Clinics |
Download full: | https://www.revistas.usp.br/clinics/article/view/162535 |
Summary: | OBJECTIVES: An objective of clinical autopsies is to determine the final cause of death and the pathological changes that may have triggered it. Despite advances in Medicine, the level of discrepancy between clinical and autopsy diagnoses remains significant. The aim of this study was to compare the data obtained from autopsies carried out at the Sa˜o Bernardo do Campo/SP Death Verification Section with clinical diagnostic hypotheses proposed during medical care. METHOD: This was a retrospective study involving the comparison of necroscopic reports issued by the Sa˜o Bernardo do Campo/Sa˜o Paulo Death Verification Section in 2014 and 2015 and the Cadaver Referral Guides completed by attending physicians prior to the necroscopic examination. RESULTS: A total of 465 cases were analyzed. In general, discrepancies between the clinical diagnostic hypothesis and the autopsy diagnosis occurred in 28% of the cases. A logistic regression model, with diagnostic discrepancy as a response variable and sex, age, duration of care, type of institution providing medical care and organ system as explanatory variables, was fit to the data; the results indicated that all explanatory variables with the exception of organ system are not significant (p40.132). CONCLUSIONS: Discrepancies between clinical diagnostic hypotheses and autopsy diagnoses continue to occur, despite new developments in complementary examinations and therapies. The odds of a discrepancy when patients present with diseases of the cardiac system are greater than those when there are problems in the vascular, endocrine and neurological systems. |
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Evaluation of the discrepancy between clinical diagnostic hypotheses and anatomopathological diagnoses resulting from autopsiesAutopsyMedical EerrorsCause of DeathDiagnosisOBJECTIVES: An objective of clinical autopsies is to determine the final cause of death and the pathological changes that may have triggered it. Despite advances in Medicine, the level of discrepancy between clinical and autopsy diagnoses remains significant. The aim of this study was to compare the data obtained from autopsies carried out at the Sa˜o Bernardo do Campo/SP Death Verification Section with clinical diagnostic hypotheses proposed during medical care. METHOD: This was a retrospective study involving the comparison of necroscopic reports issued by the Sa˜o Bernardo do Campo/Sa˜o Paulo Death Verification Section in 2014 and 2015 and the Cadaver Referral Guides completed by attending physicians prior to the necroscopic examination. RESULTS: A total of 465 cases were analyzed. In general, discrepancies between the clinical diagnostic hypothesis and the autopsy diagnosis occurred in 28% of the cases. A logistic regression model, with diagnostic discrepancy as a response variable and sex, age, duration of care, type of institution providing medical care and organ system as explanatory variables, was fit to the data; the results indicated that all explanatory variables with the exception of organ system are not significant (p40.132). CONCLUSIONS: Discrepancies between clinical diagnostic hypotheses and autopsy diagnoses continue to occur, despite new developments in complementary examinations and therapies. The odds of a discrepancy when patients present with diseases of the cardiac system are greater than those when there are problems in the vascular, endocrine and neurological systems.Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2019-09-23info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/xmlhttps://www.revistas.usp.br/clinics/article/view/16253510.6061/clinics/2019/e1197Clinics; Vol. 74 (2019); e1197Clinics; v. 74 (2019); e1197Clinics; Vol. 74 (2019); e11971980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/162535/156347https://www.revistas.usp.br/clinics/article/view/162535/156348Copyright (c) 2019 Clinicsinfo:eu-repo/semantics/openAccessZerbini, TalitaSinger, Julio M.Leyton, Vilma2019-09-23T17:23:54Zoai:revistas.usp.br:article/162535Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2019-09-23T17:23:54Clinics - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Evaluation of the discrepancy between clinical diagnostic hypotheses and anatomopathological diagnoses resulting from autopsies |
title |
Evaluation of the discrepancy between clinical diagnostic hypotheses and anatomopathological diagnoses resulting from autopsies |
spellingShingle |
Evaluation of the discrepancy between clinical diagnostic hypotheses and anatomopathological diagnoses resulting from autopsies Zerbini, Talita Autopsy Medical Eerrors Cause of Death Diagnosis |
title_short |
Evaluation of the discrepancy between clinical diagnostic hypotheses and anatomopathological diagnoses resulting from autopsies |
title_full |
Evaluation of the discrepancy between clinical diagnostic hypotheses and anatomopathological diagnoses resulting from autopsies |
title_fullStr |
Evaluation of the discrepancy between clinical diagnostic hypotheses and anatomopathological diagnoses resulting from autopsies |
title_full_unstemmed |
Evaluation of the discrepancy between clinical diagnostic hypotheses and anatomopathological diagnoses resulting from autopsies |
title_sort |
Evaluation of the discrepancy between clinical diagnostic hypotheses and anatomopathological diagnoses resulting from autopsies |
author |
Zerbini, Talita |
author_facet |
Zerbini, Talita Singer, Julio M. Leyton, Vilma |
author_role |
author |
author2 |
Singer, Julio M. Leyton, Vilma |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Zerbini, Talita Singer, Julio M. Leyton, Vilma |
dc.subject.por.fl_str_mv |
Autopsy Medical Eerrors Cause of Death Diagnosis |
topic |
Autopsy Medical Eerrors Cause of Death Diagnosis |
description |
OBJECTIVES: An objective of clinical autopsies is to determine the final cause of death and the pathological changes that may have triggered it. Despite advances in Medicine, the level of discrepancy between clinical and autopsy diagnoses remains significant. The aim of this study was to compare the data obtained from autopsies carried out at the Sa˜o Bernardo do Campo/SP Death Verification Section with clinical diagnostic hypotheses proposed during medical care. METHOD: This was a retrospective study involving the comparison of necroscopic reports issued by the Sa˜o Bernardo do Campo/Sa˜o Paulo Death Verification Section in 2014 and 2015 and the Cadaver Referral Guides completed by attending physicians prior to the necroscopic examination. RESULTS: A total of 465 cases were analyzed. In general, discrepancies between the clinical diagnostic hypothesis and the autopsy diagnosis occurred in 28% of the cases. A logistic regression model, with diagnostic discrepancy as a response variable and sex, age, duration of care, type of institution providing medical care and organ system as explanatory variables, was fit to the data; the results indicated that all explanatory variables with the exception of organ system are not significant (p40.132). CONCLUSIONS: Discrepancies between clinical diagnostic hypotheses and autopsy diagnoses continue to occur, despite new developments in complementary examinations and therapies. The odds of a discrepancy when patients present with diseases of the cardiac system are greater than those when there are problems in the vascular, endocrine and neurological systems. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-09-23 |
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/162535 10.6061/clinics/2019/e1197 |
url |
https://www.revistas.usp.br/clinics/article/view/162535 |
identifier_str_mv |
10.6061/clinics/2019/e1197 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/162535/156347 https://www.revistas.usp.br/clinics/article/view/162535/156348 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2019 Clinics info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2019 Clinics |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf application/xml |
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; Vol. 74 (2019); e1197 Clinics; v. 74 (2019); e1197 Clinics; Vol. 74 (2019); e1197 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_ |
1800222764592791552 |