Resumen de Estado actual y utilidad de la autopsia clínica en una unidad de cuidados intensivos pediátricos
Patricia García Soler, M.C. Martínez Ferriz, S. Martín Carballido, Guillermo Milano Manso
Backgrounds The autopsy is a diagnostic tool in decline over the last few decades. Our purpose is to describe the autopsy rates, the relationship between clinical and post-mortem diagnosis to evaluate the current overall usefulness of the autopsy.
Patients and methods Retrospective review of all cases in which clinical autopsy was performed between January 2004 and December 2009 in a paediatric intensive care unit (PICU) of a tertiary care hospital.
Results Of 154 deaths in the PICU during the study period, 23 autopsies were performed (rate 14.9%). Autopsy rates decreased over the study period; from 26% in 2004 to 11% in 2009. There was a complete correlation (class V) in seven patients (29.1%). Some missed minor diagnosis (class IV) were found in four patients. Five patients had class III discrepancies, and four had class II discrepancies. Major diagnoses were missed in three (17.4%) patients, with a potencial adverse impact on survival and that could have changed management in life (Class IA). In three cases (13%) the autopsy results led to parents having genetic counselling.
Conclusions The autopsy rate in our country is low when compared to other developed countries. The fact that in 69.6% of cases the autopsy revealed new findings related with the illness that caused or contributed to death shows that the reasons for performing the autopsy are still valid.
