Discrepancies between clinical and autopsy diagnosis in traumatic death cases in Siriraj Hospital

Keywords : autopsy , forensic , discrepancies ,
Publish : June 15, 2016
Total Download : 6

Tippailin Phinjirapong1 M.D., Sakda Sathirareuangchai1 M.D., Banjerd Praditsuktavorn2 M.D.
1Department of Forensic Medicine and 2Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
 
ABSTRACT
 
Background: Hospital autopsy has been questioned regarding its utility, effectiveness, and validity. However, some discrepancies between clinical and autopsy diagnosis has been shown in previous study.While forensic autopsy, which is mostly done in traumatic death, has not been evaluated for its usefulness, the authors would like to determine its value to give the alternative diagnosis.
Methods: Medical records and autopsy reports of the deceased at Siriraj hospital during 2012-2014 were reviewed and analyzed. The discrepancies between clinical and autopsy diagnosis are classifi ed into 6 classes, including major discrepancies (class I and II), minor discrepancies (class III and IV), non-discrepancy (class V), and non-classifi able (class VI).
Results: 84 patients were included in this study. Major discrepancies were found in 14 cases, with 6 cases in class I (7.1%), and 8 cases in class II (9.5%), while minor discrepancies were found in 29 cases (class III = 18 cases (21.4%), class IV = 11 cases (13.1%)).Class I discrepancies were found in diagnosis as followed; chest injury (3 cases), natural disease (2 cases), and abdominal injury (1 case).
Conclusion: The discrepancies between clinical and autopsy diagnosis in this study demonstrate the signifi cance of the autopsy as an important investigation tool in traumatic cases. Forensic autopsy should be engaged in tertiary care center for both legal procedure and quality improvement.

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Address of editorial Corresponce
✎  Vorachai Sirikulchayanonta, MD, Editor-in-Chief: Asian Archives of Pathology, Faculty of Science, Rangsit University, Pathumthani 12000, Thailand.
✉  Email address: asianarchpath@gmail.com, vorachai7@gmail.com