Correlation of antemortem diagnoses and postmortem diagnoses in a preliminary survey - any discrepancies?

Abstract

Background: The postmortem examination is a veritable means of ascertaining the correct diagnoses. Over the years, there has been a severe drop in the number of requests for postmortem examination despite its numerous advantages and benefits. The study is aimed at showing the pivotal role of the autopsy in medical education and qualitative patients' care.

Materials and Methods: A retrospective review of (total number of cases) full post mortem dissections done, some including histological examination were comprehensively reviewed. The clinical diagnoses were evaluated along with postmortem diagnoses. The ages of the patients were reviewed along with organ systems thought to have problems and those missed.

Results: Out of 62 complete autopsy dissections, 25 (40.32%) of our cases were discrepant while 37 (59.68%) cases were concordant. Most cases of discrepant diagnoses were in the 4^th decade of life accounting for 9 (36%) of discrepant cases. While diagnoses were more usually correct in the 3^rd decade of life accounting for 10 (27.05%) of concordant diagnoses. The bulk of incorrect diagnoses was in the 3^rd to 7^th decade of life. Five commonly missed diagnoses were 4 cases of systemic hypertension, 3 cases of intracranial haemorrhage, 4 cases of lobar pneumonia, 3 cases of hepatocellular carcinoma and 2 cases of renal cell carcinoma accounting for 16 (64%) of all missed cases.

Conclusion: The postmortem examination remains the gold standard for the ultimate diagnoses. All health institutions especially secondary and tertiary health institutions should put structures in place for conducting autopsies and auditing patients care.

Keywords: Correlation, antemortem, postmortem, diagnoses, discrepancies