Autopsy Standardized Mortality Review: A Pilot Study Offering a Methodology for Improved Patient Outcomes.

Autor:	Early CA; Department of Pathology, The Brody School of Medicine at East Carolina University, Greenville, NC, USA., Gilliland MGF; Department of Pathology, The Brody School of Medicine at East Carolina University, Greenville, NC, USA., Kelly KL; Department of Pathology, The Brody School of Medicine at East Carolina University, Greenville, NC, USA., Oliver WR; Regional Forensic Center, Knoxville, TN, USA., Kragel PJ; Department of Pathology, The Brody School of Medicine at East Carolina University, Greenville, NC, USA.
Jazyk:	angličtina
Zdroj:	Academic pathology [Acad Pathol] 2019 Feb 12; Vol. 6, pp. 2374289519826281. Date of Electronic Publication: 2019 Feb 12 (Print Publication: 2019).
DOI:	10.1177/2374289519826281
Abstrakt:	A standardized mortality review of hospital autopsies identified discrepancies between clinical diagnoses and autopsy findings, unexpected deaths, adequacy of diagnostic workup, presence of adverse event, and type of a quality issue if present. The standardized review elements were chosen based on a review of quality metrics commonly used by hospitals. The review was completed by the pathologist based on their initial autopsy findings. The final autopsy report was later reviewed to confirm the initial review findings. Major discrepancies in diagnosis were categorized as class I or II based on the modified Goldman criteria. Ninety-six hospital autopsy cases from January 2015 to February 2018 were included in the study. The overall major discrepancy rate was 27%. Class I discrepancies, where a diagnosis found at autopsy might have improved survival had it been made premortem, were identified in 16% of cases. Categories associated with increased discrepancy rates included unexpected deaths, inadequate workup, abnormal labs or imaging not addressed, and certain quality issues. Deaths not expected at admission but expected at the time of death, those with adverse events, those within 48 hours of a procedure, those within 48 hours of admission, those with physician-specific quality issues, and those with system or process issues were not significantly related to diagnostic accuracy. Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu