scholarly journals Cause of death during the first 24 hours after hospitalization: An autopsy study

2020 ◽  
Vol 26 (3) ◽  
pp. 113-118
Author(s):  
Radmila Janković ◽  
Elena Jordanova ◽  
Jovan Jevtić ◽  
Ljubica Simić ◽  
Marko Baralić
Keyword(s):  
Clinical Diagnosis ◽  
Cause Of Death ◽  
Clinical Data ◽  
Fatal Outcome ◽  
Postmortem Examination ◽  
Autopsy Study ◽  
Ischemic Lesion ◽  
Bowel Infarction ◽  
Emergency Hospitalization

Introduction/Objective Postmortem examination has a significant role in evaluating the quality of health care. The objective of the paper is to analyze the cause of death as determined by postmortem examination in patients who had undergone emergency hospitalization and had subsequently died within 24h, as well as the factors that contributed to the fatal outcome and correlation with available clinical data. Methods the analysis included autopsy reports and protocols, as well as clinical data from medical records and autopsy referrals during the three year period (2018-2020) for patients who had undergone a postmortem examination at the Insitute of Pathology, Medical Faculty, University of Belgrade. The correlation between the clinical diagnosis and postmortem findings was evaluated using Goldman criteria. Results the patients analysed were predominantly male (52/90; 58%). Women were statistically significantly older than men (p=0.024). The most common clinical diagnosis was cardiovascular disease (32.2%). The majority of the patients reported experiencing the first symptoms a few hours before seeking medical help (80%). The majority of the patients were being treated for chronic disease (80%) before hospitalization. The immediate cause of death determined by postmortem examination was most commonly heart failure (38/90, 42.2%). The most common clinically unrecognised causes of death include: bronchopneumonia (8/90), myocarditis (3/90), acute ischemic lesion/acute myocardial infarction (3/90) and bowel infarction (3/90). Conclusion the correlation between clinical and postmortem findings is very important because it enables the discovery of diagnostic and treatment errors and promotes new knowledge crucial for medical advancement.

Clinical Diagnoses and Autopsy Findings: A Retrospective Analysis of 252 Cases in Greece

2005 ◽  
Vol 129 (2) ◽  
pp. 210-214
Author(s):  
Chaido Spiliopoulou ◽  
Stavroula Papadodima ◽  
Nikolaos Kotakidis ◽  
Antonios Koutselinis
Keyword(s):  
Retrospective Analysis ◽  
Clinical Diagnosis ◽  
Cause Of Death ◽  
Diagnostic Errors ◽  
Postmortem Diagnosis ◽  
Autopsy Findings ◽  
Quality Of Patient Care ◽  
Clinical Diagnoses ◽  
Unexpected Findings

Abstract Context.—Despite medical and technologic advances, clinicians may misdiagnose a patient's situation and the cause of death. Autopsy may be valuable in uncovering the most frequent diagnostic pitfalls and helping clinicians to learn and to develop the medical art and science. Objective.—To compare the clinical diagnoses with postmortem findings and evaluate the frequency of diagnostic errors assessed by autopsies. Design.—Retrospective analysis of the protocols of 252 consecutive cases of adult patients autopsied in the Department of Forensic Medicine and Toxicology of Athens Medical School during the period 1999–2003. The outcome measures included concordance between diagnosis before death and at autopsy, sex, age, and length of hospitalization of the patient. Results.—In 73 cases (29%), the autopsy findings confirmed the clinical diagnosis and the cause of death suggested by the clinicians. In 45 cases (19%), the clinical diagnosis and the cause of death suggested by the clinicians were discordant with the autopsy findings. In 105 cases (42%), the autopsy requests did not include any suggestion about the cause of the patient's death. In 7 cases (3%), several diagnoses were suggested by the clinicians, and in 16 cases (6%), the comparison between clinical and postmortem diagnosis was not possible. The most frequently misdiagnosed diseases were coronary disease and pulmonary embolism. Conclusions.—It is concluded from this study that autopsies may reveal unexpected findings that are of critical importance and that a continued emphasis on autopsy evaluation is necessary to improve the quality of patient care.

scholarly journals A high degree of knee flexion after TKA promotes the ability to perform high-flexion activities and patient satisfaction in Asian population

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Hyuk-Soo Han ◽  
Jong Seop Kim ◽  
Bora Lee ◽  
Sungho Won ◽  
Myung Chul Lee
Keyword(s):  
Quality Of Life ◽  
Patient Satisfaction ◽  
Clinical Data ◽  
Knee Flexion ◽  
Male Gender ◽  
Flexion Angle ◽  
Knee Flexion Angle ◽  
High Flexion ◽  
Standing Up

Abstract Background This study investigated whether achieving a higher degree of knee flexion after TKA promoted the ability to perform high-flexion activities, as well as patient satisfaction and quality of life. Methods Clinical data on 912 consecutive primary TKA cases involving a single high-flexion posterior stabilized fixed-bearing prosthesis were retrospectively analyzed. Demographic and clinical data were collected, including knee flexion angle, the ability to perform high-flexion activities, and patient satisfaction and quality of life. Results Of the cases, 619 (68%) achieved > 130° of knee flexion after TKA (high flexion group). Knee flexion angle and clinical scores showed significant annual changes, with the maximum improvement seen at 5 years and slight deterioration observed at 10 years postoperatively. In the high flexion group, more than 50% of the patients could not kneel or squat, and 35% could not stand up from on the floor. Multivariate analysis revealed that > 130° of knee flexion, the ability to perform high-flexion activities (sitting cross-legged and standing up from the floor), male gender, and bilateral TKA were significantly associated with patient satisfaction after TKA, while the ability to perform high-flexion activities (sitting cross-legged and standing up from the floor), male gender, and bilateral TKA were significantly associated with patient quality of life after TKA. Conclusions High knee flexion angle (> 130°) after TKA increased the ease of high-flexion activities and patient satisfaction. The ease of high-flexion activities also increased quality of life after TKA in our Asian patients, who frequently engage in these activities in daily life.

scholarly journals Update on Data Reuse in Health Care

2017 ◽  
Vol 26 (01) ◽  
pp. 24-27 ◽  
Author(s):  
C. Safran
Keyword(s):  
Clinical Data ◽  
Legal Framework ◽  
Data Reuse ◽  
Policy Initiatives ◽  
Clinical Databases ◽  
Real World Evidence ◽  
Policy Frameworks ◽  
Potential Risks ◽  
Barriers To Use

Summary Objective: Reuse of clinical data has broad use in clinical, research, governmental, and business settings. This summary provides an update on the benefits, barriers to use with large clinical databases, policy frameworks that have been formulated, and challenges. Methods: This report highlights some recent publications on the diverse uses of clinical data and some policy initiatives to promote reuse. It also contains the opinions of the author. Results: Although many examples of the benefits of data reuse have been documented, this summary also reviews why the quality of clinical data needs to be the focus of future informatics work. Conclusion: The promise of reusing data outweighs potential risks, but concerns about privacy and the need to modernize our legal framework will be necessary to realize the full benefits of real-world evidence.

Septicemia as a cause of death in burns: An autopsy study

Burns ◽  
2006 ◽  
Vol 32 (5) ◽  
pp. 545-549 ◽  
Author(s):  
B.R. Sharma ◽  
D. Harish ◽  
Virendar Pal Singh ◽  
Sumedha Bangar
Keyword(s):  
Cause Of Death ◽  
Autopsy Study

Ethical Decisions in Neonatal Intensive Care Units: The Dutch Experience

PEDIATRICS ◽  
1992 ◽  
Vol 90 (5) ◽  
pp. 729-732
Author(s):  
Pieter J. J. Sauer
Keyword(s):  
Quality Of Life ◽  
Intensive Care ◽  
The Netherlands ◽  
Neonatal Intensive Care ◽  
Fatal Outcome ◽  
Modern Technology ◽  
Withholding Treatment ◽  
Intensive Care Treatment ◽  
Best Interest

Modern technology makes it possible to keep more sick, extremely small, and vulnerable neonates alive. Many neonatologists in the Netherlands believe they should be concerned not only about the rate of survival of their patients, but also about the way the graduates of their care do, in fact, survive beyond the neonatal period. In most cases, we use all available methods to keep newborns alive. However, in some instances there is great concern about the quality of life, if the newborn should survive; here questions do arise about continuing or withholding treatment. In this commentary, I present my impression of the opinions held by a majority of practicing neonatologists in the Netherlands, as well as some personal thoughts and ideas. Recently, a committee convened by the Ministers of Justice and Health in the Netherlands issued an official report regarding the practice of euthanasia and the rules of medical practice when treatment is withheld.1 In this report of more than 250 pages, only 2 pages focus on the newborn. The following conclusions were made in this small section of the report. In almost one half of the instances of a fatal outcome in a neonatal intensive care unit in the Netherlands, discussions about sustaining or withholding treatment did take place at some stage of the hospital stay. A consideration of the future quality of life was always included in the discussion. The committee agreed with doctors interviewed for the report that there are circumstances in which continuation of intensive care treatment is not necessarily in the best interest of a neonate.

Socialization Scores in Psychiatric Patients and Their Implications for the Diagnosis of Personality Disorders

1986 ◽  
Vol 31 (2) ◽  
pp. 138-141 ◽  
Author(s):  
Kevin Standage
Keyword(s):  
Personality Disorder ◽  
Parental Care ◽  
Personality Disorders ◽  
General Hospital ◽  
Clinical Diagnosis ◽  
Psychiatric Patients ◽  
Psychiatric Service ◽  
Strong Association

The distribution scores on the Socialization (So) scale of the California Psychologial Inventory was examined in a series of 83 admissions to a general hospital psychiatric service. The series was divided into groups of low and high scorers (Low So and High So). Low So scorers were younger than high scorers and had a raised mean Neuroticism score. A strong association was found between So scores and the quality of parental care which patients reported receiving from their fathers. Other parental attributes are reported. Patients with a clinical diagnosis of personality disorder were found in the Low So, but not the High So group.

scholarly journals Screening for gastric cancer: East and West, features of diagnostic criteria

2020 ◽  
pp. 73-78
Author(s):  
A. A. Avanesyan ◽  
O. V. Chukina ◽  
Yu. V. Kokovina ◽  
T. M. Chirkina ◽  
I. G. Bakulin
Keyword(s):  
Quality Of Life ◽  
Gastric Cancer ◽  
Diagnostic Criteria ◽  
Cause Of Death ◽  
Tumor Development ◽  
Risk Groups ◽  
The West ◽  
Systematic Screening ◽  
Diagnosis Of Cancer

Gastric cancer is the leading cause of death among all cancer deaths. Identification of risk groups and special carcinogens will prevent the development of the tumor or detect it in the early stages, which will significantly increase the quality of life of patients with high risks of developing gastric cancer. For the timely detection of tumor development, it is optimal to use systematic screening. Undoubtedly, the approaches to the diagnosis of cancer have significant differences in the countries of the West and the East.

scholarly journals Mors Gaudet Succurrere Vitae. The Role of Clinical Autopsy in Preventing Litigation Related to the Management of Liver and Digestive Disorders

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1436
Author(s):  
Stefano D’Errico ◽  
Martina Zanon ◽  
Michela Peruch ◽  
Monica Concato ◽  
Martina Padovano ◽  
...  
Keyword(s):  
Risk Management ◽  
Clinical Diagnosis ◽  
Cause Of Death ◽  
Clinical Performance ◽  
Improve Patient Safety ◽  
Methodological Approach ◽  
Post Mortem ◽  
Accurate Analysis ◽  
Hepatic Diseases

Over the last 50 years, the number of clinical autopsies has decreased, but their role in assessing cause of death and clinical performance is still acknowledged. Few publications have studied their role in malpractice claim prevention. The paper aims to highlight the role of clinical autopsy in preventing errors and improve healthcare quality. A retrospective study was conducted on 28 clinical autopsies performed between 2015 and 2021 on patients dead unexpectedly after procedures for the diagnosis and treatment of digestive and hepatic diseases. After an accurate analysis of medical records and consultation with healthcare professionals, all cases were subjected to autopsy and histopathology. The data obtained were analyzed and shared with the risk-management team to identify pitfalls and preventive strategies. Post-mortem evaluations confirmed the clinical diagnosis only in six cases (21.4%). Discordances were observed in 10 cases (35.7%). In the remaining 12 cases (42.9%) the clinical diagnosis was labeled as “unknown” and post-mortem examinations made it possible to document the cause of death. Post-mortem examinations can concretely enrich hospital prevention systems and improve patient safety. The methodological approach outlined certainly demonstrates that, even in the risk-management field, “mors gaudet succurrere vitae” (“death delights in helping life”).

Sign in / Sign up

Export Citation Format

Share Document