Comparison of the final clinical and autopsy detected diagnoses in sepsis
Abstract
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.