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    Autopsy Standardized Mortality Review: A Pilot Study Offering a Methodology for Improved Patient Outcomes

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    Author
    Early, C. A.; Gilliland, M. G. F.; Kelly, K. L.; Oliver, W. R.; Kragel, P. J.
    Abstract
    A standardized mortality review of hospital autopsies identified discrepancies between clinical diagnoses and autopsy findings, unexpected deaths, adequacy of diagnostic workup, presence of adverse event, and type of a quality issue if present. The standardized review elements were chosen based on a review of quality metrics commonly used by hospitals. The review was completed by the pathologist based on their initial autopsy findings. The final autopsy report was later reviewed to confirm the initial review findings. Major discrepancies in diagnosis were categorized as class I or II based on the modified Goldman criteria. Ninety-six hospital autopsy cases from January 2015 to February 2018 were included in the study. The overall major discrepancy rate was 27%. Class I discrepancies, where a diagnosis found at autopsy might have improved survival had it been made premortem, were identified in 16% of cases. Categories associated with increased discrepancy rates included unexpected deaths, inadequate workup, abnormal labs or imaging not addressed, and certain quality issues. Deaths not expected at admission but expected at the time of death, those with adverse events, those within 48 hours of a procedure, those within 48 hours of admission, those with physician-specific quality issues, and those with system or process issues were not significantly related to diagnostic accuracy.
    URI
    http://hdl.handle.net/10342/7955
    Subject
    diagnostic discrepancy, mortality review, quality assurance, unexpected mortality, autopsy rate
    Date
    2019-02-12
    Citation:
    APA:
    Early, C. A., & Gilliland, M. G. F., & Kelly, K. L., & Oliver, W. R., & Kragel, P. J.. (February 2019). Autopsy Standardized Mortality Review: A Pilot Study Offering a Methodology for Improved Patient Outcomes. , (), - . Retrieved from http://hdl.handle.net/10342/7955

    Display/Hide MLA, Chicago and APA citation formats.

    MLA:
    Early, C. A., and Gilliland, M. G. F., and Kelly, K. L., and Oliver, W. R., and Kragel, P. J.. "Autopsy Standardized Mortality Review: A Pilot Study Offering a Methodology for Improved Patient Outcomes". . . (), February 2019. September 27, 2023. http://hdl.handle.net/10342/7955.
    Chicago:
    Early, C. A. and Gilliland, M. G. F. and Kelly, K. L. and Oliver, W. R. and Kragel, P. J., "Autopsy Standardized Mortality Review: A Pilot Study Offering a Methodology for Improved Patient Outcomes," , no. (February 2019), http://hdl.handle.net/10342/7955 (accessed September 27, 2023).
    AMA:
    Early, C. A., Gilliland, M. G. F., Kelly, K. L., Oliver, W. R., Kragel, P. J.. Autopsy Standardized Mortality Review: A Pilot Study Offering a Methodology for Improved Patient Outcomes. . February 2019; (): . http://hdl.handle.net/10342/7955. Accessed September 27, 2023.
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