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  1. Autopsies in children : Are they still useful ?

    Article - En anglais

    Background 

    Autopsy has traditionally been the criterion for determining cause of death and has played a major role in medical education and quality control.

    With increasing use of bedside technology, however, autopsy rates have steadily declined.

    Objective 

    To identify (1) trends in pediatric autopsy rates during the past decade, (2) concordance between antemortem and postmortem diagnoses, and (3) patient characteristics influencing autopsy rates or diagnostic yield.

    Methods 

    All pediatric deaths between January 1,1984, and December 31,1993, were retrospectively reviewed.

    Data collection included demographics for all patients, and length of stay, diagnostic imaging studies, antemortem diagnoses, and autopsy findings for patients with autopsies.

    Autopsy diagnoses were compared with antemortem findings and classified according to their concordance.

    Results 

    Of 297 pediatric deaths, autopsies were performed on 107 patients (36%). Autopsy rates did not change significantly during the study period.

    Autopsies were not associated with patient gender, race, or insurance status, but increased significantly with age.

    Autopsies were performed in 26% of infants 12 months or younger, 60% of children between 13 to 60 months of age, and 100% of children 61 months or older (X2 ; P<. 001).

    In 34% of cases, new diagnoses were made at autopsy, including 7 cases where new findings, if known before death, would likely have resulted in a change in treatment or improved survival. (...)

    Mots-clés Pascal : Autopsie, Dépistage, Etiologie, Facteur qualité, Exploration clinique, Concordance discordance, Diagnostic, Enfant, Homme, Etude cas, Pédiatrie

    Mots-clés Pascal anglais : Autopsy, Medical screening, Etiology, Q factor, Clinical investigation, Concordance discordance, Diagnosis, Child, Human, Case study, Pediatrics

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

    Cote : 98-0310788

    Code Inist : 002B27C. Création : 27/11/1998.