La crisis de la autopsia / The autopsy in crisis

In the Western world the autopsy rate is declining at an alarming rate. In the United States of America the rate in some academic hospitals is less than 7 percent of all hospital deaths. This decline has been documented and deplored in many countries, articles and books. Suggestions on how to resuscitate the autopsy range from mandatory in all hospital deaths to economic bonuses to the doctors obtaining the highest autopsy rate. All in vain, the autopsy decline continues. Pathologists deploring this decline blamed clinical colleagues, new social attitudes, the litigious nature of modern society, but few have questioned a procedure little changed in more than a century. Perhaps the time has come to abandon the ÒclassicÓ autopsy and rethink the procedure so as to make it useful, alluring and indispensable for the contemporary, concerned clinician

Reflexiones sobre la práctica actual de la anatomía patológica en Chile / Reflections on the current state of anatomic pathology in Chile

The present article reviews the most relevant aspects of the practice of Anatomic Pathology in Chile. The importance of biopsy and autopsy are analysed, in particular the consequences of the fall in the number of autopsies performed in our hospitals, in the recent decades. The modern pathologist is confronted with two situations: the renovation of the value of the autopsy and the acquisition of new diagnostic technologies, both not usually considered in the classical morphologic approach of Pathology. The ways to solve these problems in a discipline that is still a fundamental specialty in modern medicine are analyzed

Análisis del valor actual de la autopsia / Current value of autopsy

Para determinar el valor actual de la autopsia en la vereficación del diagnóstico clinico, se analizaron 50 autopsias no seleccionadas correspondientes al 51%de todas las muertes por patología quirúrgica digestiva ocurridas entre 1985 y 1990. En 20 de los 50 autopsias existían omisiones diagnósticas mayores y en 9 de las 20, el pronóstico de los enfermos hubiera podido mejorar si hubieran conocidos estos diagnósticos antes de la muerte. Comparando los hallazgos de autopsia actuales con los de una serie anterior de nuestro hospital, resulta claro que las causas insospechadas de muerte varían de una época a otra. Este estudio sugiere que además de sus roles en el suministro de datos epidemiológicos, control de nuevos procedimientos diagnósticos y terapéuticos, y provisión de tejidos u órganos para transplante, la autopsia sigue siendo imprescindible para el control de calidad del diagnóstico clínico

Autopsy experience in Barbados

Although there is world-wide concern about the decrase in autopsy srates, to the authors' knowledge, the rates in Barbados have never been documented. The calculation of the non-coroner's autopsy rates and concordance score, and the possible value of the autopsies performed at the Queen Elizabeth Hospital constitute this paper