Are Autopsies still Useful in the Intensive Care Unit?

Abstract

As early as 1912, autopsy was noted by Cabot to be a medical procedure to obtain a diagnosis in complex cases, to provide quality assessment of clinical practice, and to improve understanding of medical limitations [1, 2]. Anderson et al. [3] defined quality assessment as the quantitative evaluation of results or outcomes ranged within predefined acceptable limits Although in the United States, the institutional requirements of the Accreditation Council for Graduate Medical Education stated that a sufficient number of autopsies should be performed to maintain quality of patient care and for educational purposes, the autopsy rate has fallen over recent decades, from 50% in the 1940s to 10% in the 1980s [4]. This decline has been attributed to a number of factors, including:

• the fear of diagnostic errors being detected at autopsy;

• heary work for the pathologists;

• the high non-reimbursable cost involved in the procedure;

• difficulties in obtain consent from the family; and

• the greater sensitivity and specificity of modern diagnostic techniques [5, 6].