A Study of Consecutive Autopsies in a Medical ICU: A Comparison of Clinical Cause of Death and Autopsy Diagnosis

Objective To determine the degree of concordancebetween clinical cause of death and autopsy diagnosis in a medical ICU(MICU) setting. Design Retrospective medical chartand autopsy report review. Setting MICU in a tertiaryreferral hospital. Patients Consecutive admissions toan MICU over a 2-year period from January 1, 1994, to December 31,1995. Interventions None. Measurements andmain results One thousand eight hundred patients were admittedto the MICU during the study period. There were 401 in-ICU deaths(22.3%). The autopsy rate was 22.7% (91 of 401). The mean ± SD ageof the autopsied patients (55.1 ± 13.5 years) was lower thanthose without autopsy (62.4 ± 15.2 years; p Conclusion Younger patients tended to have a higher autopsy rate than olderpatients. The discordance between the clinical cause of death andpostmortem diagnosis was 19.8%. In 44.4% of the discordant cases, knowledge of the correct diagnosis would have alteredtherapy.