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Discrepâncias clínico-patológicas e achados cardiovasculares em 409 autópsias consecutivas

2011; Sociedade Brasileira de Cardiologia (SBC); Volume: 97; Issue: 6 Linguagem: Inglês

10.1590/s0066-782x2011005000111

1678-4170

Aline Fusco Fares, Jorge A Fares, Gislaine Fusco Fares, José Antônio Cordeiro, Marcelo Arruda Nakazone, Patrı́cia Maluf Cury,

Forensic Entomology and Diptera Studies

Discrepancies between clinical and autopsy diagnoses persists worldwide.We evaluated autopsies in a university hospital in order to assess the accuracy of clinical cardiovascular diagnosis compared to postmortem findings.Four hundred nine consecutive autopsies between 2003 and 2006 were analyzed in a tertiary-care hospital in São José do Rio Preto, SP, Brazil. The comparison of clinic-pathological cardiovascular findings was performed using Goldman's discrepancies classification.Autopsy rate at the hospital was 8%. Cardiovascular causes of death represented 42.8% (175 out of 409 patients) of autopsy diagnoses. In 98 (56%) patients, there were major discrepancies (class I and II), representing a large proportion of misdiagnoses for mesenteric infarction (84.6%), acute myocardial infarction (64.7%), aorta dissection (64.2%), and pulmonary embolism (62.5%). Highest concordance rates were observed in congestive heart failure (59%) and acute ischemic stroke (58.8%). Age, sex, length of stay and the last admission unit at the hospital were not associated with Goldman criteria.Clinic-autopsy discrepancies concerning cardiovascular death remain high in Brazil, despite technological resources available. Moreover, our findings reinforce the importance of postmortem examination in contributing to medical care improvement.