Death within 30 days of fine needle aspiration: Post-mortem confirmation of FNA diagnoses and the contribution of FNA to patient mortality
| Autor: | David S. Priemer, William A. Berry, Harvey M. Cramer, Dean A. Hawley |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Histology Concordance Biopsy Fine-Needle Autopsy 030218 nuclear medicine & medical imaging Pathology and Forensic Medicine Surgical pathology 03 medical and health sciences 0302 clinical medicine medicine Humans In patient Mortality Medical diagnosis skin and connective tissue diseases neoplasms Aged Retrospective Studies medicine.diagnostic_test Quality assessment business.industry General surgery General Medicine Middle Aged Death body regions surgical procedures operative Fine-needle aspiration 030220 oncology & carcinogenesis Female business |
| Zdroj: | Diagnostic Cytopathology. 46:993-1003 |
| ISSN: | 8755-1039 |
| DOI: | 10.1002/dc.23985 |
| Popis: | BACKGROUND Fine needle aspiration (FNA) diagnoses are usually confirmed via surgical pathology or via evaluation of clinical outcomes. However, such confirmation may not occur for patients who die shortly after FNA, and autopsy may be a useful quality assessment tool in these cases. Also, there is little data investigating the relationship between FNA and mortality. We sought to demonstrate the autopsy as a quality assessment tool for the FNA and assess the contribution of FNA to mortality in patients who die soon after the procedure. METHODS A search of our database was performed from 1992 to 2016 for patients who were autopsied after dying within 30 d of an FNA. Concordance between findings from FNA, autopsy, and any intervening surgical pathology material was determined. Finally, a subjective determination of the likelihood that FNAs contributed to deaths was made by reviewing autopsy reports. The contribution was categorised as either "unlikely", "possible", or "probable". RESULTS Fifty-eight patients (average age = 58 y) met the search criteria. Thirty-six (62%) patients had malignancies. Surgical pathology material was obtained concurrently or following FNA in 20 cases (34%). There was 73% concordance between FNA and autopsy findings, which compares to 80% concordance between FNA and surgical pathology diagnoses. The FNA was determined to be at least possibly contributory to death in 7/58 cases (3 cases designated as "probable," and 4 as "possible"). CONCLUSION Autopsy can be used to validate FNA diagnoses and, like surgical pathology, confirms that FNA diagnoses are mostly accurate. However, in a small number of patients, FNA can precipitate death. |
| Databáze: | OpenAIRE |
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