[Comparison of the final clinical and autopsy detected diagnoses in sepsis]. / Sopostavlenie zaklyuchitel'nogo klinicheskogo i patologo-anatomicheskogo diagnozov pri sepsise.

With sepsis, more than a third of patients die, while the immediate causes of death may remain unknown. Autopsy largely helps to establish them. OBJECTIVE: Identification of discrepancies in the final clinical and autopsy detected diagnoses in patients with sepsis who died in the surgical intensive care unit. MATERIAL AND METHODS: 107 cases of patients with sepsis who died in the Department of Surgical Resuscitation of the Republican Scientific Center for Emergency Medical Care in 2020-2021 were studied. Autopsy was performed in 60 (56%) of the deceased. The autopsy was performed within 24 hours after the death was pronounced. The final clinical and pathoanatomic diagnoses were compared in accordance with the International Goldman System and the Russian Classification of categories of diagnosis discrepancies. RESULTS: As a result of autopsies, 3 (5%) of the deceased had a discrepancy in the diagnoses of class I and 14 (23%) - class II according to the International Goldman System. During his lifetime, diseases or their complications were not recognized in 17 (28%) cases, mainly acute myocardial infarction of type 2 (3 cases) and liver abscesses (3 cases). CONCLUSION: A pathoanatomic autopsy is a modern and important diagnostic tool that can clarify the causes of death.

[Prevalence rate of fatal and nonfatal pulmonary artery thromboembolism at a multimodality hospital].

The authors carried out a retrospective analysis of the causes of fatal and nonfatal pulmonary artery thromboembolisms (PATE) based on the materials of 204 post-mortem examinations of the patients having died at the Republican Scientific Centre for Emergency Medical Care. Of these, PATE as the underlying cause of death was registered in 151 (74.0%) cases, and the remaining 53 (26.0%) patients were found to have had lesions of the pulmonary artery branches on the background of another concomitant fatal pathology. In-life diagnosis of PATE had been made in 42.6% of cases only. Damage to the inferior vena cava (JVC) was recorded in the case history only in 19.9% of those having died of PATE, while of the patients with nonfatal forms of thromb о embolism, having died of other causes, lesions of the venous system had been registered by the attending physicians only in 11.3% of cases. The authors made a conclusion on the importance of improving the organizational, therapeutic and diagnostic measures aimed at prevention and early detection of embolus-threatening phlebothrombosis, as well as implementing more radical and safer methods of preventing PATE.