THE ROLE OF AUTOPSY IN MEDICAL INTENSIVE CARE UNIT: COMPARISON OF CLINICAL AND POSTMORTEM DIAGNOSES

BACKGROUND Autopsy is an essential auditing tool in clinical practice. The autopsy teaches us not only what is killing people right now, but points to what will kill us in the near future. This is the first autopsy study in Medical Intensive Care Unit (MICU) in India as per our knowledge. METHODS Retro-prospective study of total of 141 medical autopsies of MICU deaths performed in the Department of Pathology during a period of three years. A meticulous study was performed to compare ante-mortem clinical diagnosis and post-mortem final cause of death. Cases showing a discrepancy between the clinical diagnosis and post-mortem final cause of death were categorized into IV classes according to Goldman classification. RESULTS Maximum autopsies were performed in 21-40 years (58.15%). Female preponderance noted. Non-infectious aetiology was most common cause of death (50%), of which lesions of respiratory system were the most common (33.8%). Amongst the infections, pneumonia was the most common cause of death (29.23%). Discrepancies between ante-mortem and post-mortem were noted in 63 cases (44.68%). Class I and class II discrepancies were 49.21% and 44.45%, respectively. CONCLUSION Our study stresses that routine autopsy is still very useful in MICU and emphasis must be placed on autopsy evaluation for the improvement of quality of patient care.