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  1. Who dies at A & E ? the role of forensic pathology in the audit of mortality in an emergency medicine department.

    Article - En anglais

    The authors reviewed a total of 481 deaths, which occurred in an accident and emergency (A & E) department of a major general hospital, over a 3-year-period, from 1 January, 1992 to 31 December, 1994.

    Of these, 428 (89.0%) were referred to the coroner, with full medico-legal autopsies being conducted in 236 (55.1%) of the latter.

    There was a marked preponderance of male subjects (male : female ratio=1.86) and. not unexpectedly. the likelihood of an autopsy being performed decreased with the patient's age.

    Nevertheless. all patients who died from trauma (or unnatural causes) underwent autopsies, irrespective of age.

    In all, autopsies were conducted for 70 traumatic and 166 natural deaths. with the mean age (95% CI) of the former group being some 19 years less than that of the latter (33.2 (28.4-38.1) vs. 52.0 (48.6-55.4), P<0.001).

    A comparison of the provisional causes of death (as recorded by the attending physicians in their clinical notes) with the autopsy findings yielded a higher diagnostic accuracy for traumatic deaths than for natural fatalities (correct diagnoses : 44/70 vs. 36/166 ; discordant diagnoses : 2/70 vs. 24/166, P<0.01).

    This difference was accentuated after the patients who were dead upon arrival were excluded (44/55 vs. 36/96 ; 2/55 vs. 24/96, P<0.005). (...)

    Mots-clés Pascal : Service hospitalier, Urgence, Mortalité, Audit, Epidémiologie, Homme, Traumatisme, Indice gravité, Cause, Autopsie, Diagnostic, Statistique, Singapour, Asie

    Mots-clés Pascal anglais : Hospital ward, Emergency, Mortality, Audit, Epidemiology, Human, Trauma, Severity score, Cause, Autopsy, Diagnosis, Statistics, Singapore, Asia

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 97-0030290

    Code Inist : 002B30A01A2. Création : 21/05/1997.