ABSTRACT
CONTEXT: The autopsy rate gradually decreased during 1950-1999, and increased during the most recent decade (2000-2009). The diagnostic inaccuracy rate was continuously high during the 60 years. OBJECTIVE: To investigate disagreement between the pathological and clinical diagnosis during 60 years (1950-2009). DATA SOURCES: A 60-year retrospective study was carried out on the 4140 autopsy cases performed in Zhejiang University School of Medicine. RESULTS: The highest number of cases was 1037 during 1960-1969, while the lowest was 102 during 1990-1999. During the 1999-2009 period, 978 cases were completed, which ranked second within the 60 years. The total clinical misdiagnosis rate was 46.38%, while the highest was 73.82% in 2000-2009. During the 60 years, the diseases associated with highest diagnostic inaccuracy rates were circulatory diseases (76.97%), cancer (60.99%), and brain diseases (54.48%). The invasive fungal infection rate was 1.84% of the 4140 cases, and the diagnostic inaccuracy rate for this condition reached as high as 86.10%. In the autopsied disease spectrum over the 60 years, the most common diseases were respiratory (1349, 32.58%), circulatory (495, 11.96%), and brain diseases (424, 10.24%). CONCLUSION: Although the number of autopsies decreased from 1950 to 1999, it increased from 2000 to 2009, while the discordance rate between clinical and autopsy diagnosis remained high throughout.
