Original ArticleThe Role of Autopsy in the Intensive Care Unit
Section snippets
PATIENTS AND METHODS
We reviewed the medical records, Acute Physiology and Chronic Health Evaluation III database, and autopsy reports of patients treated in adult ICUs of the Mayo Medical Center, Rochester, Minn, from January 1, 1998, through December 31, 2000. The ICUs included the medical ICU, coronary care unit, neurologic ICU, surgical and trauma ICUs at Saint Marys Hospital, and a multidisciplinary ICU at Rochester Methodist Hospital. The medical staff make rounds in these units every day, and medical
RESULTS
During the study period, 1597 deaths occurred in the ICUs. Autopsies were performed in 527 patients (33%). Patients’ mean ± SD age was 59.6±18.7 years. Autopsy reports were available in 455 adult patients, of whom 19 (4%) had type I errors and 78 (17%) had type II errors (Table 1). The other 72 patients did not meet the inclusion criteria because they died in the pediatric ICU (46); they died in the chronic ventilator unit (5), which is not an ICU; or they did not authorize their medical charts
DISCUSSION
In this study, we found that one third of patients who died in the ICU underwent autopsy, and type I or II errors were found in 21%. There were no significant differences in age, sex, or length of hospital stay among patients with and without errors. Major diagnoses with impact on treatment were missed in 4% of patients. Pericardial tamponade was the most common type I error, occurring in 4 patients. Infections were the most common type II errors. Errors were more likely to occur in transplant
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