[5] Autopsy Rates – Contributory Factors at an Urban Teaching Hospital

RA Burch-Smith, M Fidelia-Lambert. Howard University Hospital, Washington, DC

Background: There has been a worldwide decline in hospital autopsy rates, which has been attributed to many factors. The detrimental effect of this dwindling autopsy rate on quality health care delivery is well documented. The aim of this study is to identify contributory factors to declining autopsy rates at an urban teaching hospital, and to suggest methodologies to reverse this trend.
Design: A retrospective review of hospital death notices and autopsy reports to ascertain causative factors and attitudes which help determine autopsy rates at an urban teaching hospital was performed. This study examined whether pre-analytic autopsy practices influenced the frequency at which autopsies were performed. Information obtained from the Notice of Death (NOD) forms which was reviewed include length of hospital stay, attending physician for the deceased, age of decedent, and next of kin notified. The turn around time to final autopsy sign out was also examined.
Results: For the year under review the majority of admitted patients who expired did not undergo postmortem examination.

Our results indicate that the decedent's next of kin who was notified; the post mortem interval and the completeness of NOD forms are important factors that determine whether or not an autopsy is performed on the deceased. The age of decedent; length of hospital stay and the treating attending physician did not influence the incidence of autopsy.
Conclusions: There is a need for re-defining hospital policies and procedures regarding autopsies. These may include: stricter monitoring of methods used to request autopsies, compliance to death notice form requisite, better performance expectation for post-mortem examination and reporting, and dissemination of educational material to patient families & health care professionals. Some of the causative factors to the declining autopsy rate are reversible and hospitals can implement guidelines to help alleviate some of these issues and thus improve declining autopsy rates.
Category: Autopsy

Wednesday, March 24, 2010 9:30 AM

Poster Session V # 1, Wednesday Morning


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