The correct diagnosis of the causes of death helps to save lives
Keywords:
autopsy, causes of death, quality in health, medical informatics.Abstract
Correctly diagnosing the causes of death helps save lives, this work is carried out with the aim of showing how the process that leads a patient to death should be studied and its causes should be specified with greater accuracy, based on the Cuban experience. The importance of the accuracy and relationship of clinical and morphological diagnoses is emphasized. The need to perform autopsies with the highest quality and make the most of its benefits. Autopsy-related meetings are explained. The Cuban experience with the automated system of registration and control of pathological anatomy and the main results. In conclusion, it is shown how the process that leads a patient to death should be studied and how to pinpoint its causes, the Cuban experience and the important role of autopsy in saving lives.Downloads
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References
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6. Rubio Delgado E, Rodríguez-Mazahua L, Palet Guzmán JA, Cervantes J, Sánchez Cervantes JL, Peláez-Camarena SG, et al. Analysis of Medical Opinions about the Nonrealization of Autopsies in a Mexican Hospital Using Association Rules and Bayesian Networks. Scientific Programming. 2018[acceso: 12/10/2019]; 2018:4304017. DOI:10.1155/2018/4304017
7. Van den Tweel JG, Wittekind C. The medical autopsy as quality assurance tool in clinical medicine: dreams and realities. Virchows Arch. 2016[acceso: 25/04/20];468:75-81. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4751188/
8. Turnbull A, Osborn M, Nicholas N. Hospital autopsy: Endangered or extinct? J Clin Pathol. 2015[acceso: 12/11/2019];68(8):1-4. DOI:10.1136/jclinpath-2014-202700
9. Blokker BM. Weustink AC, Hunink MGM, Oosterhuis JW. Autopsy rates in the Netherlands: 35 years of decline. PLoS ONE. 2017[acceso: 12/12/2019];12(6):e0178200. Disponible en: https://doi.org/10.1371/journal.pone.0178200
10. Suleiman DE. Reviving hospital autopsy in Nigeria: An urgent call for action. Annals of Nigerian Medicine. 2015 [acceso: 12/11/2019];9(2):39-40. DOI:10.4103/0331-3131.177941
11. Saud Khan M, Barnett WR, Gohara AF, Torrison J, Coletta C, Assaly R. Autopsy learning module: a tool for assessing self-reflection and practice improvement competency. International Journal of Medical Education. 2017 [acceso: 12/12/2019];8:421-22. DOI: 10.5116/ijme.5a2b.a8ea
12. Goldman L, Sayson R, Robbins S, Cohn LH, Bettmann M, Weisberg M. The value of autopsy in three medical eras. N Engl J Med. 1983[acceso: 12/12/2019];308:1000-5. Disponible en: https://www.nejm.org/doi/pdf/10.1056/NEJM198304283081704
13. Battle RM, Pathak D, Humble CG, Key CR, Vanatta PR, Hill RB, Anderson RE. Factors influencing discrepancies between pre- and post-mortem diagnoses. JAMA. 1987[acceso: 12/12/2019];258:339-44. DOI: 10.1001/jama.1987.03400030055031
14. Coradazzi AL, Morganti AL, Montenegro MR. Discrepancies between clinical diagnoses and autopsy findings. Braz J Med Biol Res. 2003 [acceso: 12/11/2019];36(3):385-91. Disponible en: http://dx.doi.org/10.1590/S0100-879X2003000300014
15. Marshall HS, Milikowski C. Comparison of Clinical Diagnoses and Autopsy Findings. Six-Year Retrospective Study. Arch Pathol Lab Med. 2017[acceso: 25/04/20];141(9):1262-66. Disponible en: https://www.archivesofpathology.org/doi/10.5858/arpa.2016-0488-OA
16. Jackett L, McLean C. Hospital autopsy audit: discordant primary clinical diagnoses are found in 20% of cases in a reducing autopsy case load. Selection bias or significant findings? Pathology. 2015[acceso: 25/04/20];47(6):499-502. Disponible en: https://journals.lww.com/pathologyrcpa/fulltext/2015/10000/Hospita-l_autopsy_audit___discordant_primary.1.aspx
17. Bürgesser M, Calafat P, Campos D, Diller A. Discrepancias entre diagnósticos clínicos y hallazgos de autopsia. Rev. Medicina Buenos Aires. 2011 [acceso: 12/11/2019]; 71(2):135-8. Disponible en: http://medicinabuenosaires.com/revistas/vol71-11/2/v71_n2_p.135-138.pdf
18. García Reyes AM, Alberty Murillo AG, Avila Matute AN, Seaman Peñalva DM, Espinoza Aguiriano IA, Zavala Carranza JC, et al. Discrepancias entre el diagnóstico Clínico y Anatomo-Patológico en el Hospital Escuela Universitario De Honduras. Rev Cient Cienc Méd. 2016 [acceso: 12/10/2019];19(2):20-26. Disponible en: http://www.scielo.org.bo/scielo.php?script=sci_arttext&pid=S1817-74332016000200004&lng=es
19. Espinosa-Brito AD, Hurtado de Mendoza-Amat J. In Defense of Clinical Autopsy and Its Practice in Cuba. MEDICC Review. 2017 [acceso 12/11/2019];19(1):37-41. Disponible en: https://www.scielosp.org/article/ssm/content/raw/?resource_ssm_-path=/media/assets/medicc/v19n1/1555-7960-medicc-19-01-0037.pdf
20. WHO. European Health Information Gateway. Autopsy rate for all deaths. Copenhagen: WHO Regional Office for Europe; 2016. [acceso: 12/12/2019]. Disponible en: https://gateway.euro.who.int/en/indicators/hfa_545-6410-autopsy-rate-for-all-deaths/
21. Hooper J, Williamson A, Editors. Autopsy in the21st Century. Best Practices and Future Directions. Suiza: Springer; 2019. [acceso: 01/19/2020]. Disponible en: https://doi.org/10.1007/978-3-319-98373-8
22. WHO. Verbal autopsy standards: ascertaining and attributing cause of death. Geneva: WHO; 2016. [acceso: 12/12/2019]. Disponible en: https://www.who.int/healthinfo/statistics/verbalautopsystandards/en/
23. Fariña J, Millana C, Fernández-Aceñero MJ, Furió V, Aragoncillo P, Martín VG, et al. Ultrasonographic autopsy (echopsy): a new autopsy technique. Virchows Arch. 2002[acceso: 25/04/20];440:635-9. Disponible en: https://link.springer.com/article/10.1007/s00428-002-0607-z
24. Geller SA. Who Will Do My Autopsy? Arch Pathol Lab Med. 2015 [acceso: 12/12/2019];139(5):578-80. DOI: 10.5858/arpa.2014-0396-ED
25. Bosman FT, Lehr H-A Quality in pathology: how good is good? An introduction. Virchows Arch. 2016 [acceso: 12/10/2019]; 468:1-4. DOI: 10.1007/s00428-015-1896-3
26. Davis GG, Winters GL, Fyfe BS, Hooper JE, Iezzoni JC, Johnson RL, et al. Report and Recommendations of the Association of Pathology Chairs. Autopsy Working Group. Academic Pathology. 2018 [acceso: 12/10/2019]; 5:1-10. DOI: 10.1177/2374289518793988
27. Llombart-Bosch A, Hurtado de Mendoza Amat J, Álvarez Santana R, Ferrández-Izquierdo A, Borrajero Martínez I. Evaluación de la calidad de los diagnósticos premortem de causas de muerte en las autopsias del Hospital Clínico Universitario de Valencia (1985-1992). Rev Esp Patol. 2009 [acceso: 12/10/2019];42(3):191-6. Disponible en: http://www.patologia.es/volumen42/vol42-num3/pdf%20patologia%2042-3/42-03-04.pdf
28. Arango Astorga P, Cabrera Nicolau L, Hurtado de Mendoza Amat J. Necesidad de un sistema informático de registro y control en Anatomía Patológica para la red hospitalaria en Cuba. Revista Cubana de Informática Médica. 2015[acceso: 12/10/2019];7(2):185-95. Disponible en: http://www.rcim.sld.cu/revista_31/articulo_htm/necesidadsistema.htm
29. Arango Astorga P, Cabrera Nicolau L, Hurtado de Mendoza Amat J. Sistema informático para la gestión del conocimiento en los departamentos de anatomía patológica. Revista Cubana de Informática Médica. 2019 [acceso: 01/19/2020];11(2):56-73. Disponible en: http://revinformatica.sld.cu/index.php/rcim/article/view/326/0
2. OPS/OMS. Clasificación Estadística Internacional de Enfermedades y Problemas Relacionados con la Salud. Décima Revisión. Washington DC;1997. Vol.3. [acceso: 12/10/2019]. Disponible en: http://ais.paho.org/classifications/Chapters/pdf/Volume3.pdf
3. Seuc AH, Fernández L, Mirabal M, Rodríguez A, Rodríguez CA. Cuban Application of Two Methods for Analyzing Multiple Causes of Death. MEDICC Review. 2018 [acceso: 12/10/2019];20(3):30-5. Disponible en: http://mediccreview.org/wp-content/uploads/2018/07/MRJuly2018-seuc-cuban-application.pdf
4. Sánchez H. Autopsy rate and physician attitudes toward autopsy. New York: Medscape; 2017. [actualizado: 16/07/209; acceso: 12/10/2019]. Disponible en: https://emedicine.medscape.com/article/1705948-overview
5. Hurtado de Mendoza-Amat J. La autopsia como fortaleza del sistema de salud de Cuba. Rev Cubana Salud Pública. 2016[acceso12/10/2019];42(2):[aprox. 12 p]. Disponible en: http://www.revsaludpublica.sld.cu/index.php/spu/article/view/714/590
6. Rubio Delgado E, Rodríguez-Mazahua L, Palet Guzmán JA, Cervantes J, Sánchez Cervantes JL, Peláez-Camarena SG, et al. Analysis of Medical Opinions about the Nonrealization of Autopsies in a Mexican Hospital Using Association Rules and Bayesian Networks. Scientific Programming. 2018[acceso: 12/10/2019]; 2018:4304017. DOI:10.1155/2018/4304017
7. Van den Tweel JG, Wittekind C. The medical autopsy as quality assurance tool in clinical medicine: dreams and realities. Virchows Arch. 2016[acceso: 25/04/20];468:75-81. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4751188/
8. Turnbull A, Osborn M, Nicholas N. Hospital autopsy: Endangered or extinct? J Clin Pathol. 2015[acceso: 12/11/2019];68(8):1-4. DOI:10.1136/jclinpath-2014-202700
9. Blokker BM. Weustink AC, Hunink MGM, Oosterhuis JW. Autopsy rates in the Netherlands: 35 years of decline. PLoS ONE. 2017[acceso: 12/12/2019];12(6):e0178200. Disponible en: https://doi.org/10.1371/journal.pone.0178200
10. Suleiman DE. Reviving hospital autopsy in Nigeria: An urgent call for action. Annals of Nigerian Medicine. 2015 [acceso: 12/11/2019];9(2):39-40. DOI:10.4103/0331-3131.177941
11. Saud Khan M, Barnett WR, Gohara AF, Torrison J, Coletta C, Assaly R. Autopsy learning module: a tool for assessing self-reflection and practice improvement competency. International Journal of Medical Education. 2017 [acceso: 12/12/2019];8:421-22. DOI: 10.5116/ijme.5a2b.a8ea
12. Goldman L, Sayson R, Robbins S, Cohn LH, Bettmann M, Weisberg M. The value of autopsy in three medical eras. N Engl J Med. 1983[acceso: 12/12/2019];308:1000-5. Disponible en: https://www.nejm.org/doi/pdf/10.1056/NEJM198304283081704
13. Battle RM, Pathak D, Humble CG, Key CR, Vanatta PR, Hill RB, Anderson RE. Factors influencing discrepancies between pre- and post-mortem diagnoses. JAMA. 1987[acceso: 12/12/2019];258:339-44. DOI: 10.1001/jama.1987.03400030055031
14. Coradazzi AL, Morganti AL, Montenegro MR. Discrepancies between clinical diagnoses and autopsy findings. Braz J Med Biol Res. 2003 [acceso: 12/11/2019];36(3):385-91. Disponible en: http://dx.doi.org/10.1590/S0100-879X2003000300014
15. Marshall HS, Milikowski C. Comparison of Clinical Diagnoses and Autopsy Findings. Six-Year Retrospective Study. Arch Pathol Lab Med. 2017[acceso: 25/04/20];141(9):1262-66. Disponible en: https://www.archivesofpathology.org/doi/10.5858/arpa.2016-0488-OA
16. Jackett L, McLean C. Hospital autopsy audit: discordant primary clinical diagnoses are found in 20% of cases in a reducing autopsy case load. Selection bias or significant findings? Pathology. 2015[acceso: 25/04/20];47(6):499-502. Disponible en: https://journals.lww.com/pathologyrcpa/fulltext/2015/10000/Hospita-l_autopsy_audit___discordant_primary.1.aspx
17. Bürgesser M, Calafat P, Campos D, Diller A. Discrepancias entre diagnósticos clínicos y hallazgos de autopsia. Rev. Medicina Buenos Aires. 2011 [acceso: 12/11/2019]; 71(2):135-8. Disponible en: http://medicinabuenosaires.com/revistas/vol71-11/2/v71_n2_p.135-138.pdf
18. García Reyes AM, Alberty Murillo AG, Avila Matute AN, Seaman Peñalva DM, Espinoza Aguiriano IA, Zavala Carranza JC, et al. Discrepancias entre el diagnóstico Clínico y Anatomo-Patológico en el Hospital Escuela Universitario De Honduras. Rev Cient Cienc Méd. 2016 [acceso: 12/10/2019];19(2):20-26. Disponible en: http://www.scielo.org.bo/scielo.php?script=sci_arttext&pid=S1817-74332016000200004&lng=es
19. Espinosa-Brito AD, Hurtado de Mendoza-Amat J. In Defense of Clinical Autopsy and Its Practice in Cuba. MEDICC Review. 2017 [acceso 12/11/2019];19(1):37-41. Disponible en: https://www.scielosp.org/article/ssm/content/raw/?resource_ssm_-path=/media/assets/medicc/v19n1/1555-7960-medicc-19-01-0037.pdf
20. WHO. European Health Information Gateway. Autopsy rate for all deaths. Copenhagen: WHO Regional Office for Europe; 2016. [acceso: 12/12/2019]. Disponible en: https://gateway.euro.who.int/en/indicators/hfa_545-6410-autopsy-rate-for-all-deaths/
21. Hooper J, Williamson A, Editors. Autopsy in the21st Century. Best Practices and Future Directions. Suiza: Springer; 2019. [acceso: 01/19/2020]. Disponible en: https://doi.org/10.1007/978-3-319-98373-8
22. WHO. Verbal autopsy standards: ascertaining and attributing cause of death. Geneva: WHO; 2016. [acceso: 12/12/2019]. Disponible en: https://www.who.int/healthinfo/statistics/verbalautopsystandards/en/
23. Fariña J, Millana C, Fernández-Aceñero MJ, Furió V, Aragoncillo P, Martín VG, et al. Ultrasonographic autopsy (echopsy): a new autopsy technique. Virchows Arch. 2002[acceso: 25/04/20];440:635-9. Disponible en: https://link.springer.com/article/10.1007/s00428-002-0607-z
24. Geller SA. Who Will Do My Autopsy? Arch Pathol Lab Med. 2015 [acceso: 12/12/2019];139(5):578-80. DOI: 10.5858/arpa.2014-0396-ED
25. Bosman FT, Lehr H-A Quality in pathology: how good is good? An introduction. Virchows Arch. 2016 [acceso: 12/10/2019]; 468:1-4. DOI: 10.1007/s00428-015-1896-3
26. Davis GG, Winters GL, Fyfe BS, Hooper JE, Iezzoni JC, Johnson RL, et al. Report and Recommendations of the Association of Pathology Chairs. Autopsy Working Group. Academic Pathology. 2018 [acceso: 12/10/2019]; 5:1-10. DOI: 10.1177/2374289518793988
27. Llombart-Bosch A, Hurtado de Mendoza Amat J, Álvarez Santana R, Ferrández-Izquierdo A, Borrajero Martínez I. Evaluación de la calidad de los diagnósticos premortem de causas de muerte en las autopsias del Hospital Clínico Universitario de Valencia (1985-1992). Rev Esp Patol. 2009 [acceso: 12/10/2019];42(3):191-6. Disponible en: http://www.patologia.es/volumen42/vol42-num3/pdf%20patologia%2042-3/42-03-04.pdf
28. Arango Astorga P, Cabrera Nicolau L, Hurtado de Mendoza Amat J. Necesidad de un sistema informático de registro y control en Anatomía Patológica para la red hospitalaria en Cuba. Revista Cubana de Informática Médica. 2015[acceso: 12/10/2019];7(2):185-95. Disponible en: http://www.rcim.sld.cu/revista_31/articulo_htm/necesidadsistema.htm
29. Arango Astorga P, Cabrera Nicolau L, Hurtado de Mendoza Amat J. Sistema informático para la gestión del conocimiento en los departamentos de anatomía patológica. Revista Cubana de Informática Médica. 2019 [acceso: 01/19/2020];11(2):56-73. Disponible en: http://revinformatica.sld.cu/index.php/rcim/article/view/326/0
Published
2020-11-03
How to Cite
1.
Hurtado de Mendoza Amat JD, Montero González T de J. The correct diagnosis of the causes of death helps to save lives. Rev Cubana Med Milit [Internet]. 2020 Nov. 3 [cited 2025 Jan. 31];49(4):e0200629. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/629
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