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Báo cáo y học: "Clinical review: What is the role for autopsy in the ICU"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Clinical review: What is the role for autopsy in the ICU? | De Vlieger et al. Critical Care 2010 14 221 http ccforum.eom content 14 2 221 CRITICAL CARE REVIEW L_ Clinical review What is the role for autopsy in the ICU Greet Yvonne Agnes De Vlieger Elien Marie Jeanne Lia Mahieu and Wouter Meersseman Abstract The availability of advanced diagnostic tools has grown in the past decades. Hence a growing false belief exists that everything is known about the patient before death. Moreover intensivists may wrongly believe that autopsy findings do not contribute to the understanding of pathophysiological events. The immediate result is that few ICUs nowadays assemble enough autopsy cases with new and interesting clinicopathological features. However we believe that at least in tertiary ICUs autopsies remain a valuable examination as a tool for quality control as a way of establishing gold standards for diagnostic examinations and as an aid in developing guidelines for treatment and diagnosis of diseases frequently encountered in the ICU. Finally due to the everexpanding armamentarium of immunosuppressive agents a growing list of opportunistic infections is discovered during autopsy. The present article gives an overview of autopsy studies conducted in the ICU and discusses the pros and cons of performing these. Introduction During the past decades autopsy rates have been declining worldwide. The non-forensic clinical autopsy rate at large hospitals in the United States dropped from 41 in 1964 to 22 in 1975 1 . In spite of this decline the post-mortem examination remains clinically relevant for time-honoured reasons the information obtained helps to understand diseases it provides essential feedback for the clinician and leads to quality assessment and education and data from it are important for epidemiologists 2 . We analyzed reports that compare post-mortem cause of death with clinical diagnosis. The discrepancies Correspondence wouter.meersseman@uzleuven.be Department of General Internal Medicine Medical Intensive Care .