The number of autopsies is declining in the United States for many reasons. However, the procedure can identify a number of important and unexpected findings. The frequency of important findings is affected by a number of factors surrounding the deceased care prior to death.
Parameter
Higher Probability
Intermediate Probability
Lower Probability
type of autopsy
coroners case, private
community hospital
university hospital
duration of illness prior to death
very brief
intermediate
long
hospital care prior to death
< 24 hours
1 to 7 days
> 1 week
operative or trauma status
recent
remote
none
death
unexpected
expected
where:
• A private autopsy is one which the family requests and pays for.
Common missed diagnoses:
(1) cardiac disease
(2) pulmonary embolism
(3) aneurysm (cerebral, aortic)
(4) cancer
(5) acute or subacute hemorrhage
(6) infection
(7) surgical or medical complication
Tavora et al found that almost 20% of nonmedicolegal autopsies revealed a major discrepancy with the clinical diagnosis and that almost 30% disclosed major unexpected findings.
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